Healthcare Provider Details

I. General information

NPI: 1013363662
Provider Name (Legal Business Name): ALEXANDRA HUNG RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2016
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date: 09/19/2017
Reactivation Date: 11/28/2017

III. Provider practice location address

1241 RIVERSIDE AVE.
FORT COLLINS CO
80524
US

IV. Provider business mailing address

3915 ROCK CREEK DRIVE, UNIT B
FORT COLLINS CO
80528
US

V. Phone/Fax

Practice location:
  • Phone: 970-232-6170
  • Fax:
Mailing address:
  • Phone: 970-232-6170
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number002023867
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: