MEDICARE: DR. ALEXANDRA AMES 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	122300000X	Dentist	059704-1	NY

General Provider Information

NPI Number	:	1871049148
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEXANDRA AMES DDS

Provider Business Mailing Address
First Line	:	182 E 95TH ST APT 9D
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10128-2566
Country	:	US
Telephone Number	:	607-342-6043
Fax Number	:

Provider Business Practice Location Address
First Line	:	11956 METROPOLITAN AVE
Second Line	:
City	:	KEW GARDENS
State	:	NY
Zip	:	11415-2606
Country	:	US
Telephone Number	:	718-441-2291
Fax Number	:

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

Provider Enumeration Date	:	08/28/2016
Last Update Date	:	03/26/2020

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