Thomas G Fellner, D.D.S.
Individual provider Active NPI Dentist · Galion, OH
NPI 1114063237 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1114063237
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 19109 (OH)
- Practice address
- 102 Harding Way W
Suite 102
Galion, OH 44833-1726 - Phone
- (419) 468-4285
- Fax
- (419) 468-6724
- NPI assigned
- Jan 29, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 19109 | OH | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thomas G Fellner DDS, Inc. | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 19109 | OH | Yes |
Addresses
Primary practice location
102 Harding Way W
Suite 102
Galion, OH 44833-1726
Mailing address
102 Harding Way W
Suite 102
Galion, OH 44833-1726
Phone (419) 468-4285
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 19109 | Other | OH | DENTAL LICENSE |
Other providers in Galion, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.