Provider Demographics
NPI:1598837726
Name:ALEX, SONIA
Entity Type:Individual
Prefix:DR
First Name:SONIA
Middle Name:
Last Name:ALEX
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10438 OLIO RD
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46040-7500
Mailing Address - Country:US
Mailing Address - Phone:317-336-9922
Mailing Address - Fax:317-336-9925
Practice Address - Street 1:10438 OLIO RD
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46040-7500
Practice Address - Country:US
Practice Address - Phone:317-336-9922
Practice Address - Fax:317-336-9925
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2016-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010252A1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice