Healthcare Provider Details

I. General information

NPI: 1912474982
Provider Name (Legal Business Name): DE'JA ALEXANDER DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/29/2018
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 S CENTER ST
GOLDSBORO NC
27530-4807
US

IV. Provider business mailing address

300 S CENTER ST
GOLDSBORO NC
27530-4807
US

V. Phone/Fax

Practice location:
  • Phone: 919-947-0800
  • Fax:
Mailing address:
  • Phone: 919-947-0800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number11631
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: