Provider Demographics
NPI:1215676028
Name:WENZEL, ALEXI ANN (DDS)
Entity type:Individual
Prefix:
First Name:ALEXI
Middle Name:ANN
Last Name:WENZEL
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 GRAND AVE APT 204
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55105-2667
Mailing Address - Country:US
Mailing Address - Phone:651-955-1169
Mailing Address - Fax:
Practice Address - Street 1:8960 SPRINGBROOK DR NW STE 150
Practice Address - Street 2:
Practice Address - City:COON RAPIDS
Practice Address - State:MN
Practice Address - Zip Code:55433-5810
Practice Address - Country:US
Practice Address - Phone:763-784-7570
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-31
Last Update Date:2022-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND14734122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist