Provider Demographics
NPI:1710995931
Name:ALEXANDER, SUDHA (DDS)
Entity Type:Individual
Prefix:MRS
First Name:SUDHA
Middle Name:
Last Name:ALEXANDER
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 1:21 KELLY WAY
Mailing Address - Street 2:
Mailing Address - City:MONMOUTH JCT
Mailing Address - State:NJ
Mailing Address - Zip Code:08852
Mailing Address - Country:US
Mailing Address - Phone:732-355-0812
Mailing Address - Fax:732-583-8614
Practice Address - Street 1:1 WOODSEND DRIVE
Practice Address - Street 2:
Practice Address - City:MATAWAN
Practice Address - State:NJ
Practice Address - Zip Code:07747
Practice Address - Country:US
Practice Address - Phone:732-566-7717
Practice Address - Fax:732-583-8614
Is Sole Proprietor?:No
Enumeration Date:2006-08-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI209901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice