Provider Demographics
NPI:1376623975
Name:RENKENBERGER, ALEXANDRA SPRIGG (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:SPRIGG
Last Name:RENKENBERGER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:MRS
Other - First Name:ALLY
Other - Middle Name:
Other - Last Name:RENKENBERGER-TALTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10444 PATTERSON AVE
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23238-5102
Mailing Address - Country:US
Mailing Address - Phone:804-740-3402
Mailing Address - Fax:804-741-9948
Practice Address - Street 1:10444 PATTERSON AVE
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23238-5102
Practice Address - Country:US
Practice Address - Phone:804-740-3402
Practice Address - Fax:804-741-9948
Is Sole Proprietor?:No
Enumeration Date:2006-10-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010087331223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice