Provider Demographics
NPI:1346707007
Name:SAHYOUNI, ALEXANDER JOSEPH (DMD)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:JOSEPH
Last Name:SAHYOUNI
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 1:1400 HAWTHORNE ST STE 2
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:MN
Mailing Address - Zip Code:56308-4550
Mailing Address - Country:US
Mailing Address - Phone:320-762-2122
Mailing Address - Fax:
Practice Address - Street 1:1400 HAWTHORNE ST STE 2
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:MN
Practice Address - Zip Code:56308-4550
Practice Address - Country:US
Practice Address - Phone:320-762-2122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-28
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND14840122300000X
WI1002057122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program