Provider Demographics
NPI:1467722546
Name:MENENDEZ, ALEXANDER (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:
Last Name:MENENDEZ
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4800 NW 7TH AVE
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33127-2304
Mailing Address - Country:US
Mailing Address - Phone:305-756-3393
Mailing Address - Fax:786-313-3142
Practice Address - Street 1:4800 NW 7TH AVE
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33127-2304
Practice Address - Country:US
Practice Address - Phone:305-756-3393
Practice Address - Fax:786-313-3142
Is Sole Proprietor?:No
Enumeration Date:2012-01-06
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN121081223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL071862901Medicaid
FL071862900Medicaid