MEDICARE: DR. MICHELLE FELDEN DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	13165	NC

General Provider Information

NPI Number	:	1801538608
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MICHELLE FELDEN DMD

Provider Business Mailing Address
First Line	:	525 E 21ST ST APT 596
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28206-3879
Country	:	US
Telephone Number	:	330-329-1267
Fax Number	:

Provider Business Practice Location Address
First Line	:	1917 HOFFMAN RD
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28054-6574
Country	:	US
Telephone Number	:	980-321-7294
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2022
Last Update Date	:	07/17/2023

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