Provider Demographics
NPI:1639739378
Name:WOO, ALEXANDRA (DMD)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:WOO
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 1:1800 LENNOX FLATS DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-1480
Mailing Address - Country:US
Mailing Address - Phone:443-846-5221
Mailing Address - Fax:
Practice Address - Street 1:808 LANDMARK DR STE 221
Practice Address - Street 2:
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-4985
Practice Address - Country:US
Practice Address - Phone:410-896-1737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-14
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.026209390200000X
MD177341223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program