Provider Demographics
NPI:1285288597
Name:KITCHIN, ALEX (DDS)
Entity type:Individual
Prefix:DR
First Name:ALEX
Middle Name:
Last Name:KITCHIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:634 B ST
Mailing Address - Street 2:
Mailing Address - City:FORT RICHARDSON
Mailing Address - State:AK
Mailing Address - Zip Code:99505-6650
Mailing Address - Country:US
Mailing Address - Phone:907-384-2483
Mailing Address - Fax:
Practice Address - Street 1:634 B ST
Practice Address - Street 2:
Practice Address - City:FORT RICHARDSON
Practice Address - State:AK
Practice Address - Zip Code:99505-6650
Practice Address - Country:US
Practice Address - Phone:907-384-2483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-07-25
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901600216122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist