Provider Demographics
NPI:1437127925
Name:HENDRICKS, ALEXANDRA WARREN (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:WARREN
Last Name:HENDRICKS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1642 WESTGATE CIRCLE
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027
Mailing Address - Country:US
Mailing Address - Phone:615-373-9889
Mailing Address - Fax:615-425-0320
Practice Address - Street 1:1642 WESTGATE CIRCLE
Practice Address - Street 2:
Practice Address - City:BRENTWOOD
Practice Address - State:TN
Practice Address - Zip Code:37027-8080
Practice Address - Country:US
Practice Address - Phone:615-373-9889
Practice Address - Fax:615-425-0320
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN80561223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry