Healthcare Provider Details

I. General information

NPI: 1023936929
Provider Name (Legal Business Name): ALEXANDRA EMEIGH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2026
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26203 NOVI RD
NOVI MI
48375-1142
US

IV. Provider business mailing address

50438 COOLIDGE ST
CANTON MI
48188-3439
US

V. Phone/Fax

Practice location:
  • Phone: 248-476-9121
  • Fax:
Mailing address:
  • Phone: 248-707-9809
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2901603139
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: