Healthcare Provider Details

I. General information

NPI: 1679063804
Provider Name (Legal Business Name): ANDREA L FELEPPELLE DDS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/14/2018
Last Update Date: 05/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8871 BRECKSVILLE RD STE A
BRECKSVILLE OH
44141-1921
US

IV. Provider business mailing address

8871 BRECKSVILLE RD STE A
BRECKSVILLE OH
44141-1921
US

V. Phone/Fax

Practice location:
  • Phone: 440-526-8688
  • Fax: 440-526-0378
Mailing address:
  • Phone: 440-526-8688
  • Fax: 440-526-0378

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number30.024127
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number30.024127
License Number StateOH

VIII. Authorized Official

Name: DR. ANDREA L FELEPPELLE
Title or Position: DENTIST/OWNER
Credential: DDS
Phone: 440-526-8688