Provider Demographics
NPI:1295577567
Name:COOK, ALEXANDRA (DDS)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:COOK
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 1:4949 WORNALL RD APT 303
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64112-2579
Mailing Address - Country:US
Mailing Address - Phone:636-698-2332
Mailing Address - Fax:
Practice Address - Street 1:8575 W 110TH ST STE 310
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66210-2774
Practice Address - Country:US
Practice Address - Phone:913-345-0331
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-08
Last Update Date:2024-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS62137122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist