Provider Demographics
NPI:1427169622
Name:ALEVIZOS, DEANNA LYNN (DDS)
Entity type:Individual
Prefix:DR
First Name:DEANNA
Middle Name:LYNN
Last Name:ALEVIZOS
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 1:5533 15TH AVE S
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55417-2543
Mailing Address - Country:US
Mailing Address - Phone:612-332-1656
Mailing Address - Fax:
Practice Address - Street 1:14344 BURNHAVEN DR
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55306-4928
Practice Address - Country:US
Practice Address - Phone:952-435-5715
Practice Address - Fax:952-435-6229
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND109871223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry