Provider Demographics
NPI:1306020235
Name:JEFFREY S. ALEXANDER D.D.S.,P.C.
Entity Type:Organization
Organization Name:JEFFREY S. ALEXANDER D.D.S.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:ALEXANDER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:623-412-2439
Mailing Address - Street 1:8253 W THUNDERBIRD RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PEORIA
Mailing Address - State:AZ
Mailing Address - Zip Code:85381-4616
Mailing Address - Country:US
Mailing Address - Phone:623-412-2439
Mailing Address - Fax:623-412-3190
Practice Address - Street 1:8253 W THUNDERBIRD RD
Practice Address - Street 2:SUITE 101
Practice Address - City:PEORIA
Practice Address - State:AZ
Practice Address - Zip Code:85381-4616
Practice Address - Country:US
Practice Address - Phone:623-412-2439
Practice Address - Fax:623-412-3190
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-27
Last Update Date:2007-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ40981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty