Provider Demographics
NPI:1215561873
Name:ALEXANDRA PERI D.D.S. PLLC
Entity Type:Organization
Organization Name:ALEXANDRA PERI D.D.S. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:PERI
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:248-334-3888
Mailing Address - Street 1:44004 WOODWARD AVE
Mailing Address - Street 2:STE 200
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-5032
Mailing Address - Country:US
Mailing Address - Phone:248-334-3888
Mailing Address - Fax:
Practice Address - Street 1:44004 WOODWARD AVE
Practice Address - Street 2:STE 200
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-5032
Practice Address - Country:US
Practice Address - Phone:248-334-3888
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-23
Last Update Date:2020-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty