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NPI Code Detail

MEDICARE: ALPHA DMD, PLLC

MEDICARE: ALPHA DMD, PLLC
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
1261QD0000XDental Clinic/Center

General Provider Information

NPI Number : 1659019420
Entity Type Code : Organization
Provider Name (Legal Business Name) : ALPHA DMD, PLLC
Provider Business Mailing Address
First Line : 21003 HIGHLAND KNOLLS DR STE 100
Second Line :
City : KATY
State : TX
Zip : 77450-1565
Country : US
Telephone Number : 281-712-7271
Fax Number : 832-321-4976
Provider Business Practice Location Address
First Line : 21003 HIGHLAND KNOLLS DR STE 100
Second Line :
City : KATY
State : TX
Zip : 77450-1565
Country : US
Telephone Number : 281-712-7271
Fax Number : 832-321-4976
Authorized Official
Title or Position : OWNER
Name : DR. ALETHEA KYPRIOTAKIS
Credential : DMD
Telephone Number : 281-712-7271
Provider Enumeration Date : 05/23/2022
Last Update Date : 05/23/2022

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