MEDICARE: DR. ALEXANDRA KHAIMOV DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	050666	NY
2	1223G0001X	General Practice Dentistry	DN27369	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1023166725
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEXANDRA KHAIMOV DDS

Provider Business Mailing Address
First Line	:	8610 LEWIS RIVER RD
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33446-9597
Country	:	US
Telephone Number	:	917-992-1066
Fax Number	:

Provider Business Practice Location Address
First Line	:	8610 LEWIS RIVER RD
Second Line	:
City	:	DELRAY BEACH
State	:	FL
Zip	:	33446-9597
Country	:	US
Telephone Number	:	917-992-1066
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	01/05/2024

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