Basic Information
| Provider Information | |||||||||
| NPI: | 1003806035 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SIMPSON | ||||||||
| FirstName: | ALEXANDRA | ||||||||
| MiddleName: | MONICA | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | DDS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5006 245TH ST | ||||||||
| Address2: | |||||||||
| City: | DOUGLASTON | ||||||||
| State: | NY | ||||||||
| PostalCode: | 113621627 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7182250853 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 160 E 32ND ST | ||||||||
| Address2: | SUITE 103 | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100166004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2126833328 | ||||||||
| FaxNumber: | 2126830021 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/21/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1223G0001X | 51362 | NY | Y | Dental Providers | Dentist | General Practice |
No ID Information.