Provider Demographics
NPI:1760020614
Name:DRAGOJEVIC, ALEKSANDRA
Entity Type:Individual
Prefix:
First Name:ALEKSANDRA
Middle Name:
Last Name:DRAGOJEVIC
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 1:760 BROADWAY, ROOM 2C319
Mailing Address - Street 2:DEPARTMENT OF DENTISTRY/ ATTENTION M. RODRIGUEZ
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206
Mailing Address - Country:US
Mailing Address - Phone:718-963-8310
Mailing Address - Fax:718-630-3244
Practice Address - Street 1:760 BROADWAY, ROOM 2C319
Practice Address - Street 2:DEPARTMENT OF DENTISTRY/ ATTENTION M. RODRIGUEZ
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206
Practice Address - Country:US
Practice Address - Phone:718-963-8310
Practice Address - Fax:718-630-3244
Is Sole Proprietor?:No
Enumeration Date:2019-12-11
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX38751122300000X
NY061733122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No122300000XDental ProvidersDentist