Healthcare Provider Details

I. General information

NPI: 1962810820
Provider Name (Legal Business Name): GREGORY FELDMAN D.M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2014
Last Update Date: 05/26/2026
Certification Date: 05/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2441 NW 43RD ST STE 16
GAINESVILLE FL
32606-6676
US

IV. Provider business mailing address

2441 NW 43RD ST STE 16
GAINESVILLE FL
32606-6676
US

V. Phone/Fax

Practice location:
  • Phone: 352-887-6453
  • Fax: 352-376-1885
Mailing address:
  • Phone: 352-887-6453
  • Fax: 352-376-1885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberDN20823
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: