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General NPI Number Information
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NPI Number | 1831838085
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Entity Type | Individual
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Provider Name | LEXIS PHILLIPS DDS
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Gender | Female
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Dates
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Enumeration Date | 06/03/2022
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Last Update Date | 07/31/2024
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Provider Practice Location Address
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Address Line | 871 SAINT GEORGE AVE
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City | WOODBRIDGE
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State | NJ
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Zip | 07095-2514
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Country | US
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Telephone | 732-634-5200
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Fax |
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Provider Business Mailing Address
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Address Line | 1399 PARK AVE APT 15B
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City | NEW YORK
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State | NY
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Zip | 10029-4574
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Country | US
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Telephone | 615-438-2000
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2023010294
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 22DI03049400
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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