Manu Alexander, D.D.S.
Individual provider Active NPI General Practice Dentistry · Tucson, AZ
NPI 1720154388 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1720154388
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- License
- D5373 (AZ)
- Practice address
- 5311 E Broadway Blvd
Tucson, AZ 85711-3710 - Phone
- (520) 790-2865
- Fax
- (520) 797-1848
- NPI assigned
- Nov 27, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170216000947 | AZ | Order and Referring Only - Dentist |
2961713367 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| D5373 | AZ | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | D5373 | AZ | Yes |
Addresses
Primary practice location
5311 E Broadway Blvd
Tucson, AZ 85711-3710
Mailing address
1785 E Camino Cielo
Tucson, AZ 85718-1106
Phone (520) 742-3770
Other providers in Tucson, AZ
- Jack Lee Alexander
- Jamie Lyn Alexander
- Kolton Levi Tanner Alexander
- Laurel C Alexander
- Macie Alexander
- Shannon Marie Alexander
- Tara Selean Alexander
- Mohamed Alfaris
- Armando J Alfaro Jr.
- Ashraf Ibrahim Alfatesh
All providers in Tucson, AZ · General Practice Dentistry in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.