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General NPI Number Information
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NPI Number | 1568096477
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Entity Type | Individual
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Provider Name | ALEXANDER JOHN LOEB DDS
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Gender | Male
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Dates
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Enumeration Date | 02/29/2020
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Last Update Date | 06/05/2025
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Provider Practice Location Address
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Address Line | 385 CLINTON AVE
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City | WYCKOFF
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State | NJ
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Zip | 07481-1934
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Country | US
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Telephone | 201-891-6270
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Fax |
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Provider Business Mailing Address
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Address Line | 223 ROGERS DRUVE
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City | SCARSDALE
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State | NY
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Zip | 10583-6711
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Country | US
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Telephone | 914-424-5101
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 22DI02900900
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License Number State | NJ
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