=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427344571
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALEXIS CORBIT WASHINGTON DDS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/27/2011
-----------------------------------------------------
Last Update Date | 05/16/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1828 L ST NW STE 870
-----------------------------------------------------
City | WASHINGTON
-----------------------------------------------------
State | DC
-----------------------------------------------------
Zip | 20036-5104
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 202-785-9474
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6024 OSAGE ST STE 870
-----------------------------------------------------
City | BERWYN HEIGHTS
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20740-2771
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 919-423-5260
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | DEN1001888
-----------------------------------------------------
License Number State | DC
-----------------------------------------------------