Provider Demographics
NPI:1336159912
Name:EKE, ALEX (DMD)
Entity type:Individual
Prefix:DR
First Name:ALEX
Middle Name:
Last Name:EKE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5007 MOODY BRIDGE RD NE
Mailing Address - Street 2:
Mailing Address - City:LUDOWICI
Mailing Address - State:GA
Mailing Address - Zip Code:31316-5967
Mailing Address - Country:US
Mailing Address - Phone:636-283-1225
Mailing Address - Fax:
Practice Address - Street 1:351 COLMAR AVE
Practice Address - Street 2:
Practice Address - City:FT STEWART
Practice Address - State:GA
Practice Address - Zip Code:31314
Practice Address - Country:US
Practice Address - Phone:636-283-1225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY047-4981223G0001X
NY0474981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice