Individual provider Active NPI

Alexandra Rosemary Metzger

  • Dentist
  • Canton, OH
National Provider Identifier
1578312229
Registry record updated May 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
RES.004780 Issued in OH
Practice address
1320 Mercy Dr NW
Canton, OH 44708-2614
Phone
(330) 489-1000
NPI assigned
May 15, 2024
Last updated
May 27, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 27, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X RES.004780 OH Primary
Student in an Organized Health Care Education/Training Program 390200000X NU

Addresses

Primary practice location

1320 Mercy Dr NW
Canton, OH 44708-2614

Mailing address

5526 Bridgecreek Ave NW
Canton, OH 44718-1483
Phone (330) 437-9180

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RES.004780OHMDDentist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1715731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716768000000",
    "number": "1578312229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5526 BRIDGECREEK AVE NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447181483",
            "telephone_number": "330-437-9180"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 MERCY DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447082614",
            "telephone_number": "330-489-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "METZGER",
        "first_name": "ALEXANDRA",
        "middle_name": "ROSEMARY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-15",
        "last_updated": "2024-05-27",
        "certification_date": "2024-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "RES.004780",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.