Alexandra Demidova, DMD
Individual provider Active NPI Dentist · Fletcher, NC
NPI 1053994707 · NPPES record last updated Apr 23, 2024
Key facts
- NPI
- 1053994707
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 12288 (NC)
- Practice address
- 235 Saint John Rd
Suite 110
Fletcher, NC 28732 - Phone
- (828) 654-7450
- Fax
- (828) 654-8665
- NPI assigned
- Apr 30, 2021
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12288 | NC | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Dentist | 122300000X | 12288 | NC | Yes |
Addresses
Primary practice location
235 Saint John Rd
Suite 110
Fletcher, NC 28732
Mailing address
405 E Glensprings CT
Fletcher, NC 28732-8244
Phone (910) 884-8182
Other practice location 1
123 Hendersonville Rd
Asheville, NC 28803-2868
Phone (828) 252-4290
Other providers in Fletcher, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 23, 2024. 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.