Alexandra Nicole Masters, DMD

Individual provider Active NPI Dentist · Ellsworth Afb, SD

NPI 1295476356 · NPPES record last updated Aug 16, 2023

Key facts

NPI
1295476356
Entity type
Individual (NPI type 1)
Primary specialty
Dentist 122300000X
License
DEN.00205269 (CO)
Practice address
2900 Doolittle Dr
Ellsworth Afb, SD 57706-4821
Phone
(605) 385-3657
NPI assigned
Apr 5, 2022
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

LicenseStateTypeSpecialty
DEN.00205269COMDDentist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DEN.00205269 CO Yes

Addresses

Primary practice location

2900 Doolittle Dr
Ellsworth Afb, SD 57706-4821

Mailing address

2900 Doolittle Dr
Ellsworth Afb, SD 57706-4821
Phone (605) 856-3657

Other providers in Ellsworth Afb, SD

All providers in Ellsworth Afb, SD · Dentist in South Dakota

Sources for this page

Verify at the official NPI Registry.