Healthcare Provider Details

I. General information

NPI: 1780502971
Provider Name (Legal Business Name): ALEXANDRA LAUREN SMITH DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALEXANDRA WALKER DMD

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 07/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 HUDSON ST STE B
AMERICUS GA
31709-3339
US

IV. Provider business mailing address

204 HUDSON ST STE B
AMERICUS GA
31709-3339
US

V. Phone/Fax

Practice location:
  • Phone: 678-894-6178
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN124235
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: