MEDICARE: DR. SLOANE ALEXANDRA SPENCER DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	14044051-8903	UT
2	122300000X	Dentist	14044051-9926	UT

General Provider Information

NPI Number	:	1184454902
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SLOANE ALEXANDRA SPENCER DDS

Provider Business Mailing Address
First Line	:	9533 56TH AVE W
Second Line	:
City	:	MUKILTEO
State	:	WA
Zip	:	98275-3663
Country	:	US
Telephone Number	:	425-791-0523
Fax Number	:

Provider Business Practice Location Address
First Line	:	229 W BUTE ST APT 203
Second Line	:
City	:	NORFOLK
State	:	VA
Zip	:	23510-1415
Country	:	US
Telephone Number	:	425-791-0523
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/06/2024
Last Update Date	:	08/06/2024

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