Healthcare Provider Details

I. General information

NPI: 1245896364
Provider Name (Legal Business Name): EDWARD FEINS DMD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2019
Last Update Date: 05/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

241 RIVERVALE ROAD
RIVER VALE NJ
07675
US

IV. Provider business mailing address

241 RIVERVALE ROAD
RIVER VALE NJ
07675
US

V. Phone/Fax

Practice location:
  • Phone: 201-666-3300
  • Fax: 201-666-6055
Mailing address:
  • Phone: 201-666-3300
  • Fax: 201-666-6055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: EDWARD FEINS
Title or Position: OWNER
Credential: DMD
Phone: 201-666-3300