Healthcare Provider Details

I. General information

NPI: 1932027703
Provider Name (Legal Business Name): DEBBIE FERNG
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 PARK AVE
SAINT LOUIS MO
63104-3024
US

IV. Provider business mailing address

3949 LINDELL BLVD APT 3025
SAINT LOUIS MO
63108-3280
US

V. Phone/Fax

Practice location:
  • Phone: 314-833-2700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2026031914
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: