Provider Demographics
NPI:1962175398
Name:RIZK, ALEXANDRA
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:
Last Name:RIZK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5651 SUMNER WAY UNIT 303
Mailing Address - Street 2:
Mailing Address - City:CULVER CITY
Mailing Address - State:CA
Mailing Address - Zip Code:90230-6847
Mailing Address - Country:US
Mailing Address - Phone:410-404-9214
Mailing Address - Fax:
Practice Address - Street 1:6001 E WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:COMMERCE
Practice Address - State:CA
Practice Address - Zip Code:90040-2451
Practice Address - Country:US
Practice Address - Phone:562-776-5085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-30
Last Update Date:2023-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADDS108313122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist