Provider Demographics
NPI:1588071336
Name:BROWN, ALEXIS NICHOLE (DDS)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:NICHOLE
Last Name:BROWN
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 1:901 N WINSTEAD AVE STE 360
Mailing Address - Street 2:
Mailing Address - City:ROCKY MOUNT
Mailing Address - State:NC
Mailing Address - Zip Code:27804-8467
Mailing Address - Country:US
Mailing Address - Phone:252-740-2100
Mailing Address - Fax:252-740-2101
Practice Address - Street 1:901 N WINSTEAD AVE STE 360
Practice Address - Street 2:
Practice Address - City:ROCKY MOUNT
Practice Address - State:NC
Practice Address - Zip Code:27804-8467
Practice Address - Country:US
Practice Address - Phone:252-740-2100
Practice Address - Fax:252-740-2101
Is Sole Proprietor?:No
Enumeration Date:2014-07-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC109461223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry