Healthcare Provider Details

I. General information

NPI: 1508224098
Provider Name (Legal Business Name): VANESSA ALEXIOU D.M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VANESSA WATTS DMD

II. Dates (important events)

Enumeration Date: 01/29/2016
Last Update Date: 12/30/2025
Certification Date: 12/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

168 14TH ST SW STE B
LARGO FL
33770-6103
US

IV. Provider business mailing address

3201 WALNUT ST NE
SAINT PETERSBURG FL
33704-2350
US

V. Phone/Fax

Practice location:
  • Phone: 727-585-5494
  • Fax: 727-584-1820
Mailing address:
  • Phone: 561-703-3438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDN20772
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDN 20772
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: