Provider Demographics
NPI:1295172401
Name:ALEXANDRE, DANDLINE (DMD)
Entity type:Individual
Prefix:DR
First Name:DANDLINE
Middle Name:
Last Name:ALEXANDRE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1216 COOLIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-3721
Mailing Address - Country:US
Mailing Address - Phone:908-884-4811
Mailing Address - Fax:
Practice Address - Street 1:439 PORT RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10302-1714
Practice Address - Country:US
Practice Address - Phone:917-830-0838
Practice Address - Fax:718-816-6507
Is Sole Proprietor?:No
Enumeration Date:2013-05-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0572451223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice