Provider Demographics
NPI:1467010561
Name:GHADAMI, ALEXIS MONA (DDS)
Entity type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:MONA
Last Name:GHADAMI
Suffix:
Gender:F
Credentials:DDS
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Mailing Address - Street 1:64 SADDLE LN
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-2728
Mailing Address - Country:US
Mailing Address - Phone:516-661-7803
Mailing Address - Fax:516-354-4845
Practice Address - Street 1:631 COMMACK RD
Practice Address - Street 2:
Practice Address - City:COMMACK
Practice Address - State:NY
Practice Address - Zip Code:11725-5400
Practice Address - Country:US
Practice Address - Phone:631-499-0531
Practice Address - Fax:631-231-0561
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2025-01-02
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY0614511223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics