Provider Demographics
NPI:1023249141
Name:YOUNG, ALEXANDRA MAYES (DMD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:MAYES
Last Name:YOUNG
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:ALEXANDRA
Other - Middle Name:CHEUVRONT
Other - Last Name:MAYES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:7400 US 42
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:KY
Mailing Address - Zip Code:41042-1906
Mailing Address - Country:US
Mailing Address - Phone:859-525-2100
Mailing Address - Fax:
Practice Address - Street 1:7400 US 42
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1906
Practice Address - Country:US
Practice Address - Phone:859-525-2100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-06
Last Update Date:2024-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY87401223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100098140Medicaid