Provider Demographics
NPI:1649514928
Name:ALEXANDRA CRISTESCU, D.D.S, P.L.L.C
Entity type:Organization
Organization Name:ALEXANDRA CRISTESCU, D.D.S, P.L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:CRISTESCU
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:425-269-7298
Mailing Address - Street 1:4327 LAKE WASHINGTON BLVD NE
Mailing Address - Street 2:APT 6110
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-7886
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:175 NE GILMAN BLVD
Practice Address - Street 2:SUITE 101
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-2955
Practice Address - Country:US
Practice Address - Phone:425-391-9200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-27
Last Update Date:2012-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADENT.DE.60294426122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty