Provider Demographics
NPI:1043600083
Name:JENNIFER FINEBERG DDS PC
Entity type:Organization
Organization Name:JENNIFER FINEBERG DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:JEANNINE
Authorized Official - Last Name:MYERS-FINEBERG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:623-362-2550
Mailing Address - Street 1:6750 W DEER VALLEY RD STE C103
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85310-5955
Mailing Address - Country:US
Mailing Address - Phone:623-362-2550
Mailing Address - Fax:623-362-2552
Practice Address - Street 1:6750 W DEER VALLEY RD STE C103
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85310-5955
Practice Address - Country:US
Practice Address - Phone:623-362-2550
Practice Address - Fax:623-362-2552
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-29
Last Update Date:2015-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ4492122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty