Provider Demographics
NPI:1891434353
Name:MAI, ALEXANDRA TRAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:TRAM
Last Name:MAI
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 1:8218 WISCONSIN AVE STE 401
Mailing Address - Street 2:
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814-3142
Mailing Address - Country:US
Mailing Address - Phone:301-656-0331
Mailing Address - Fax:
Practice Address - Street 1:8218 WISCONSIN AVE STE 401
Practice Address - Street 2:
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814-3142
Practice Address - Country:US
Practice Address - Phone:301-656-0331
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD174121223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty