Provider Demographics
NPI:1003390527
Name:CARTAGENA, ALEJANDRA M (DDS)
Entity Type:Individual
Prefix:
First Name:ALEJANDRA
Middle Name:M
Last Name:CARTAGENA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10315 NW 9TH STREET CIR APT 105
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33172-3293
Mailing Address - Country:US
Mailing Address - Phone:305-318-6205
Mailing Address - Fax:
Practice Address - Street 1:10315 NW 9TH STREET CIR APT 105
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33172-3293
Practice Address - Country:US
Practice Address - Phone:305-318-6205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-20
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN248491223G0001X
MI2901022725122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice