Individual provider Active NPI

Alexandra Taylor Clemente

  • General Practice Dentistry
  • Merrick, NY
National Provider Identifier
1669158978
Registry record updated Aug 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
064832 Issued in NY
Practice address
2121 Donna Dr
Merrick, NY 11566-5518
Phone
(914) 323-8679
NPI assigned
Jun 22, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 21, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 064832 NY Primary

Addresses

Primary practice location

2121 Donna Dr
Merrick, NY 11566-5518

Mailing address

2121 Donna Dr
Merrick, NY 11566-5518
Phone (914) 323-8679

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
064832NYMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1687392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755734400000",
    "number": "1669158978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 DONNA DR",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115665518",
            "telephone_number": "914-323-8679"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 DONNA DR",
            "city": "MERRICK",
            "state": "NY",
            "postal_code": "115665518",
            "telephone_number": "914-323-8679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENTE",
        "first_name": "ALEXANDRA",
        "middle_name": "TAYLOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-22",
        "last_updated": "2025-08-21",
        "certification_date": "2025-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NY",
            "license": "064832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Merrick, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2025; 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.