Healthcare Provider Details

I. General information

NPI: 1194526327
Provider Name (Legal Business Name): ALEXIS PARRIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2025
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22329 GREENVIEW PKWY
GREAT MILLS MD
20634-3491
US

IV. Provider business mailing address

1 BROOKDALE PLZ
BROOKLYN NY
11212-3139
US

V. Phone/Fax

Practice location:
  • Phone: 301-923-4299
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number18780
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: