1215920715 NPI number — DR. ISTVAN FELKER DDS

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215920715 NPI number — DR. ISTVAN FELKER DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FELKER
Provider First Name:
ISTVAN
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215920715
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/10/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
07/17/2007
NPI Reactivation Date:
04/09/2009

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1850 SPRING RIDGE DR.
Provider Second Line Business Mailing Address:
NORTHEASTERN RULAL HEALTH CENTER
Provider Business Mailing Address City Name:
SUSANVILLE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
96130
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
530-251-5000
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1850 SPRING RIDGE DR
Provider Second Line Business Practice Location Address:
NORTHEASTERN RURAL HEALTH CENTER SUITE H
Provider Business Practice Location Address City Name:
SUSANVILLE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
96130-6100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
530-251-5000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/30/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  49311 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)