Provider Demographics
NPI:1033420005
Name:SEMIDEY, ALEJANDRO (DMD)
Entity Type:Individual
Prefix:
First Name:ALEJANDRO
Middle Name:
Last Name:SEMIDEY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 SW 64TH AVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-4429
Mailing Address - Country:US
Mailing Address - Phone:954-581-0120
Mailing Address - Fax:
Practice Address - Street 1:4800 SW 64TH AVE
Practice Address - Street 2:SUITE 101
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-4429
Practice Address - Country:US
Practice Address - Phone:954-581-0120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-24
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN19110122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist