Provider Demographics
NPI:1396414207
Name:MCGUINESS, ALEXANDER JAKE (DDS)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:JAKE
Last Name:MCGUINESS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 W COURT DR
Mailing Address - Street 2:
Mailing Address - City:CENTEREACH
Mailing Address - State:NY
Mailing Address - Zip Code:11720-2328
Mailing Address - Country:US
Mailing Address - Phone:516-582-2648
Mailing Address - Fax:
Practice Address - Street 1:761 MAIN AVE STE 111
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-1080
Practice Address - Country:US
Practice Address - Phone:203-908-3170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2022-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY062438122300000X
CT13542122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist