Alexis Mierzwa, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

0401412114 Issued in VA

Practice address

650 Cedar Creek Grade
Suite 211
Winchester, VA 22601-6452

Phone

(540) 486-5111

Fax

(540) 486-5112

NPI assigned

Nov 17, 2006

Last updated

Aug 10, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439164800000",
    "number": "1629141452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "181 HAMMACK LN",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226021602",
            "telephone_number": "716-308-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 CEDAR CREEK GRADE",
            "address_2": "SUITE 211",
            "city": "WINCHESTER",
            "state": "VA",
            "postal_code": "226016452",
            "telephone_number": "540-486-5111",
            "fax_number": "540-486-5112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIERZWA",
        "first_name": "ALEXIS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2015-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401412114",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NY",
            "license": "052401",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02738663",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Randall L Midock, PHD
• Hannah Mierjeski
• Alayna Mihill
• Joseph L Mikus, MD
• Nikolas Sean Mikus, AU.D.
• Richard Emerson Miles II
• Milestone Pediatric Therapy LLC (Milestone Pediatric Therapy)

• Dentist in Winchester, VA
• Providers in Winchester, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2015; 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.