Provider Demographics
NPI:1013301662
Name:ALEXANDER, VICTORIA (DDS)
Entity type:Individual
Prefix:
First Name:VICTORIA
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 1:20 FOREST AVE
Mailing Address - Street 2:
Mailing Address - City:HAWTHORNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07506-1825
Mailing Address - Country:US
Mailing Address - Phone:646-351-3329
Mailing Address - Fax:
Practice Address - Street 1:2178 63RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11204-3058
Practice Address - Country:US
Practice Address - Phone:718-435-0045
Practice Address - Fax:718-435-1260
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI026424001223G0001X
NY0588061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice