Healthcare Provider Details

I. General information

NPI: 1891807962
Provider Name (Legal Business Name): ALEXI DEE KOSSI DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26572 BOUQUET CANYON RD
SAUGUS CA
91350-2353
US

IV. Provider business mailing address

26572 BOUQUET CANYON RD
SAUGUS CA
91350-2353
US

V. Phone/Fax

Practice location:
  • Phone: 661-297-8383
  • Fax: 661-297-8006
Mailing address:
  • Phone: 661-297-8383
  • Fax: 661-297-8006

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number42659
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: