Healthcare Provider Details

I. General information

NPI: 1922984517
Provider Name (Legal Business Name): ALEXIS NICOLE HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/12/2025
Last Update Date: 08/12/2025
Certification Date: 08/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52856 HAYES RD
MACOMB MI
48042-3507
US

IV. Provider business mailing address

355 S PARKWAY DR
CLAY MI
48001-4524
US

V. Phone/Fax

Practice location:
  • Phone: 586-697-5272
  • Fax:
Mailing address:
  • Phone: 810-395-2591
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number2902021282
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: