Healthcare Provider Details

I. General information

NPI: 1912900390
Provider Name (Legal Business Name): SHARON PATRICIA FELLER DDS, FAGD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

US NAVAL HOSPITAL VIA CONTRADA BOSCARIELLO
GRICIGNANO DI AVERSA CE
81030
IT

IV. Provider business mailing address

230 N ELMIRA AVE
RUSSELLVILLE AR
72802-9617
US

V. Phone/Fax

Practice location:
  • Phone: 81-811-6000
  • Fax:
Mailing address:
  • Phone: 479-280-1920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDE8376
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number4832
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: