Provider Demographics
NPI:1477837128
Name:DAMASCUS, ALEXI (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALEXI
Middle Name:
Last Name:DAMASCUS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:59 S GREELEY AVE
Mailing Address - Street 2:
Mailing Address - City:CHAPPAQUA
Mailing Address - State:NY
Mailing Address - Zip Code:10514-3321
Mailing Address - Country:US
Mailing Address - Phone:917-612-0579
Mailing Address - Fax:
Practice Address - Street 1:59 S GREELEY AVE
Practice Address - Street 2:
Practice Address - City:CHAPPAQUA
Practice Address - State:NY
Practice Address - Zip Code:10514-3321
Practice Address - Country:US
Practice Address - Phone:917-612-0579
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-29
Last Update Date:2011-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0557471223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry