Healthcare Provider Details

I. General information

NPI: 1760308050
Provider Name (Legal Business Name): COLTON RYAN FEINBERG DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2026
Last Update Date: 06/29/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5330 CENTURY DIVISION AVE HAGEN DENTAL CLINIC
COLUMBIA SC
29207
US

IV. Provider business mailing address

3789 TUPELO CHURCH LN
MOUNT PLEASANT SC
29429-4960
US

V. Phone/Fax

Practice location:
  • Phone: 803-751-3652
  • Fax:
Mailing address:
  • Phone: 843-277-5234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number11489
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: