Basic Information
| Provider Information | |||||||||
| NPI: | 1588313472 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FEBLES | ||||||||
| FirstName: | SAHYLI | ||||||||
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| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 22 27TH AVE SE UNIT 402 | ||||||||
| Address2: | |||||||||
| City: | MINNEAPOLIS | ||||||||
| State: | MN | ||||||||
| PostalCode: | 554144238 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7863841685 | ||||||||
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| Practice Location | |||||||||
| Address1: | 6401 S RICHARDS AVE | ||||||||
| Address2: | |||||||||
| City: | SANTA FE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 875084887 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5059845048 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 03/20/2022 | ||||||||
| LastUpdateDate: | 03/20/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 02/25/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | Y | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.