=====================================================
General NPI Number Information
=====================================================
NPI Number | 1508224098
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | VANESSA ALEXIOU D.M.D
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/29/2016
-----------------------------------------------------
Last Update Date | 12/30/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 168 14TH ST SW STE B
-----------------------------------------------------
City | LARGO
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33770-6103
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 727-585-5494
-----------------------------------------------------
Fax | 727-584-1820
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3201 WALNUT ST NE
-----------------------------------------------------
City | SAINT PETERSBURG
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33704-2350
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 561-703-3438
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223S0112X
-----------------------------------------------------
Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
-----------------------------------------------------
License Number | DN20772
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 1223S0112X
-----------------------------------------------------
Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
-----------------------------------------------------
License Number | DN 20772
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------