Healthcare Provider Details

I. General information

NPI: 1598837726
Provider Name (Legal Business Name): DR. SONIA ALEX
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2006
Last Update Date: 07/26/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10438 OLIO RD
FISHERS IN
46040-7500
US

IV. Provider business mailing address

10438 OLIO RD
FISHERS IN
46040-7500
US

V. Phone/Fax

Practice location:
  • Phone: 317-336-9922
  • Fax: 317-336-9925
Mailing address:
  • Phone: 317-336-9922
  • Fax: 317-336-9925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12010252A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: