Healthcare Provider Details

I. General information

NPI: 1598973661
Provider Name (Legal Business Name): STEVEN R FELDE DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2007
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 LANGLADE RD
ANTIGO WI
54409-2787
US

IV. Provider business mailing address

1111 LANGLADE RD
ANTIGO WI
54409-2787
US

V. Phone/Fax

Practice location:
  • Phone: 715-627-4383
  • Fax:
Mailing address:
  • Phone: 715-627-4383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number6001991-15
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: