MEDICARE: DR. ALEXANDRA FUSHI DMD

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	30.026420	OH

General Provider Information

NPI Number	:	1326667841
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEXANDRA FUSHI DMD

Provider Business Mailing Address
First Line	:	3544 MEADOWBROOK BLVD
Second Line	:
City	:	CLEVELAND HEIGHTS
State	:	OH
Zip	:	44118-3659
Country	:	US
Telephone Number	:	312-618-2777
Fax Number	:

Provider Business Practice Location Address
First Line	:	2794 SOM CENTER RD STE 7
Second Line	:
City	:	WILLOUGHBY HILLS
State	:	OH
Zip	:	44094-8491
Country	:	US
Telephone Number	:	440-944-7745
Fax Number	:

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

Provider Enumeration Date	:	04/14/2020
Last Update Date	:	01/30/2022

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