MEDICARE: ALEXIUS BANKS

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	124Q00000X	Dental Hygienist

General Provider Information

NPI Number	:	1932066131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXIUS BANKS

Provider Business Mailing Address
First Line	:	4045 E LAKE VISTA PKWY APT 103
Second Line	:
City	:	OAK CREEK
State	:	WI
Zip	:	53154-7336
Country	:	US
Telephone Number	:	262-880-0468
Fax Number	:

Provider Business Practice Location Address
First Line	:	1320 S GREENBAY RD.
Second Line	:
City	:	RACINE
State	:	WI
Zip	:	53406
Country	:	US
Telephone Number	:	262-880-0468
Fax Number	:

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

Provider Enumeration Date	:	01/08/2026
Last Update Date	:	01/08/2026

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