Alexandra N Douvas, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

019022594 Issued in IL

Practice address

20180 Governors Hwy
Suite #104
Olympia Fields, IL 60461

Phone

(708) 283-2207

Fax

(708) 283-2209

NPI assigned

Dec 27, 2006

Last updated

May 15, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Dec 17, 2019 through Dec 17, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Alexandra N. Douvas

  • Dentist
  • Olympia Fields, IL
  • NPI 1619484110
  NPD (past) Authorized official

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

{
    "created_epoch": "1167177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1210809600000",
    "number": "1639235690",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20180 GOVERNORS HWY",
            "address_2": "SUITE #104",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "60461",
            "telephone_number": "708-283-2207",
            "fax_number": "708-283-2209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20180 GOVERNORS HWY",
            "address_2": "SUITE #104",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "60461",
            "telephone_number": "708-283-2207",
            "fax_number": "708-283-2209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUVAS",
        "first_name": "ALEXANDRA",
        "middle_name": "N",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-27",
        "last_updated": "2008-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IL",
            "license": "019022594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dentist in Olympia Fields, IL
• Providers in Olympia Fields, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.