Sue B Feeley, DDS

Individual provider Active NPI General Practice Dentistry · Crestwood, KY

NPI 1326250960 · NPPES record last updated Aug 17, 2012

Key facts

NPI
1326250960
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
5959 (KY)
Practice address
6225 W Hwy 146
Crestwood, KY 40014
Phone
(502) 241-8208
Fax
(502) 241-2428
NPI assigned
May 4, 2007
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20160525001319 KY Order and Referring Only - Dentist
Practitioner - Dentist
7113101965

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 5959 KY Yes

Addresses

Primary practice location

6225 W Hwy 146
Crestwood, KY 40014

Mailing address

PO Box 1094
6225 W Hwy 146
Crestwood, KY 40014
Phone (502) 241-8208

Other providers in Crestwood, KY

All providers in Crestwood, KY · General Practice Dentistry in Kentucky

Sources for this page

Verify at the official NPI Registry.