Provider Demographics
NPI:1083739536
Name:KEITH J. ALEXANDER, D.D.S., INC.
Entity Type:Organization
Organization Name:KEITH J. ALEXANDER, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR.
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:J
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:440-331-1854
Mailing Address - Street 1:20800 WESTGATE PROFESSIONAL BLDG.
Mailing Address - Street 2:SUITE 114
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126
Mailing Address - Country:US
Mailing Address - Phone:440-331-1854
Mailing Address - Fax:440-331-8461
Practice Address - Street 1:20800 WESTGATE PROFESSIONAL BLDG.
Practice Address - Street 2:SUITE 114
Practice Address - City:FAIRVIEW PARK
Practice Address - State:OH
Practice Address - Zip Code:44126
Practice Address - Country:US
Practice Address - Phone:440-331-1854
Practice Address - Fax:440-331-8461
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH165671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty