David Alexander, D.D.S, M.S.D
Individual provider Active NPI Periodontics · Lafayette, IN
NPI 1053484600 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1053484600
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Periodontics 1223P0300X
- License
- 7083 (IN)
- Practice address
- 415 N 26TH St
Suite 303
Lafayette, IN 47904-2895 - Phone
- (765) 447-9319
- NPI assigned
- Nov 15, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7083 | IN | MD | Periodontist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 7083 | IN | Yes |
Addresses
Primary practice location
415 N 26TH St
Suite 303
Lafayette, IN 47904-2895
Mailing address
415 N 26TH St
Suite 303
Lafayette, IN 47904-2895
Phone (765) 447-9319
Other providers in Lafayette, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.