Healthcare Provider Details

I. General information

NPI: 1477320042
Provider Name (Legal Business Name): OLIVIA FENG DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/05/2023
Last Update Date: 12/05/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

707 PARNASSUS AVE
SAN FRANCISCO CA
94143-2210
US

IV. Provider business mailing address

20 ADOLPH SUTRO CT APT 202
SAN FRANCISCO CA
94131-1164
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-3276
  • Fax:
Mailing address:
  • Phone: 661-480-4686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: