Provider Demographics
NPI:1578614210
Name:VITEK-HITCHCOCK, ALEXA MARIE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALEXA
Middle Name:MARIE
Last Name:VITEK-HITCHCOCK
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 1:13173 SCHAVEY RD
Mailing Address - Street 2:
Mailing Address - City:DEWITT
Mailing Address - State:MI
Mailing Address - Zip Code:48820-9000
Mailing Address - Country:US
Mailing Address - Phone:517-277-2000
Mailing Address - Fax:517-277-2100
Practice Address - Street 1:13173 SCHAVEY RD
Practice Address - Street 2:
Practice Address - City:DEWITT
Practice Address - State:MI
Practice Address - Zip Code:48820-9000
Practice Address - Country:US
Practice Address - Phone:517-277-2000
Practice Address - Fax:517-277-2100
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI18878122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MION36390Medicare ID - Type Unspecified