Kelly Alexander, D.D.S.
Individual provider Active NPI Dentist · Cuyahoga Falls, OH
NPI 1043466071 · NPPES record last updated Nov 1, 2017
Key facts
- NPI
- 1043466071
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 22154 (OH)
- Practice address
- 2931 State Road
Cuyahoga Falls, OH 44223 - Phone
- (330) 968-2268
- NPI assigned
- Aug 11, 2008
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in OH
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170126002865 | OH | Order and Referring Only - Oral Surgery |
2365724333 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22154 | OH | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 22154 | OH | Yes |
Addresses
Primary practice location
2931 State Road
Cuyahoga Falls, OH 44223
Mailing address
PO Box 860036
Minneapolis, MN 55486-0036
Phone (330) 968-2268
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2649334 | Medicaid | OH |
Other providers in Cuyahoga Falls, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.