Provider Demographics
NPI:1649791666
Name:ALEXAS FAMILY DENTISTRY
Entity type:Organization
Organization Name:ALEXAS FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NOEL
Authorized Official - Middle Name:RAE
Authorized Official - Last Name:ALEXAS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:724-470-9750
Mailing Address - Street 1:2301 JEFFERSON AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15301-1464
Mailing Address - Country:US
Mailing Address - Phone:724-470-9750
Mailing Address - Fax:
Practice Address - Street 1:2301 JEFFERSON AVE, SUITE 3
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:PA
Practice Address - Zip Code:15301
Practice Address - Country:US
Practice Address - Phone:724-470-9750
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS040317261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental