Provider Demographics
NPI:1033872189
Name:ALEXAUNDREA SMITH D.D.S., INC.
Entity Type:Organization
Organization Name:ALEXAUNDREA SMITH D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEXAUNDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:323-296-6180
Mailing Address - Street 1:5831 OVERHILL DR
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90043-2715
Mailing Address - Country:US
Mailing Address - Phone:323-296-6180
Mailing Address - Fax:323-296-0669
Practice Address - Street 1:5831 OVERHILL DR
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90043-2715
Practice Address - Country:US
Practice Address - Phone:323-296-6180
Practice Address - Fax:323-296-0669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-15
Last Update Date:2021-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty