Alex M. Kordis, D.D.S
Individual provider Active NPI Pediatric Dentistry · Franktown, VA
NPI 1124013032 · NPPES record last updated Apr 14, 2014
Key facts
- NPI
- 1124013032
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Dentistry 1223P0221X
- License
- 0404000062 (VA)
- Practice address
- 9197 Franktown Rd
Franktown, VA 23354-2254 - Phone
- (757) 442-4819
- NPI assigned
- Sep 16, 2005
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NC
- 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 |
|---|---|---|---|---|
| I20170830002321 | NC | Practitioner - Dentist | 0143529958 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4784 | NC | MD | Pediatric Dentist |
| 0404000062 | VA | MD | Pediatric Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Carolina University | Current | Accepting new patients | |
| East Carolina University | Current |
Accepting new patients | |
| East Carolina University | Current |
Accepting new patients |
Locations
1851 Macgregor Downs Rd
Greenville, NC 27834
Phone (252) 737-7000
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | 4784 | NC | |
| Pediatric Dentistry | 1223P0221X | 4825 | NE | |
| Pediatric Dentistry | 1223P0221X | 0404000062 | VA | Yes |
Addresses
Primary practice location
9197 Franktown Rd
Franktown, VA 23354-2254
Mailing address
20280 Market St
Onancock, VA 23417-1331
Phone (757) 414-0400
Other providers in Franktown, VA
- Kimberley Gise
- Donna Marie Hartley
- Amory Hartnett Bunce
- Health Journey
- Charles Sherwood Kane
- Stuart Fred Mackler
- Angel Wynn Magette
- Pamela Reed Reynolds
- Noel Root
- Dennis Greene Savage
All providers in Franktown, VA · Pediatric Dentistry in Virginia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 14, 2014. 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.