1841508215 NPI number — KRISTI ALEXANDER D.D.S., INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841508215 NPI number — KRISTI ALEXANDER D.D.S., INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KRISTI ALEXANDER D.D.S., INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1841508215
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/20/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10425 FAIR OAKS BLVD
Provider Second Line Business Mailing Address:
SUITE 104
Provider Business Mailing Address City Name:
FAIR OAKS
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95628
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-967-6538
Provider Business Mailing Address Fax Number:
916-967-6571

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10425 FAIR OAKS BLVD
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
FAIR OAKS
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95628
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-967-6538
Provider Business Practice Location Address Fax Number:
916-967-6571
Provider Enumeration Date:
09/20/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ALEXANDER
Authorized Official First Name:
KRISTI
Authorized Official Middle Name:
LYNN
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
916-967-6538

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  47440 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)