Provider Demographics
NPI:1316312374
Name:JOSEPH FENG, D.D.S., P.C.
Entity type:Organization
Organization Name:JOSEPH FENG, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PERIODONTIST
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:FENG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:302-345-1234
Mailing Address - Street 1:521 MERCHANT DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6575
Mailing Address - Country:US
Mailing Address - Phone:405-329-6106
Mailing Address - Fax:405-329-6107
Practice Address - Street 1:521 MERCHANT DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6575
Practice Address - Country:US
Practice Address - Phone:405-329-6106
Practice Address - Fax:405-329-6107
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORMAN PERIO, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2015-12-02
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK691223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty