Provider Demographics
NPI:1447044300
Name:PASSARELLI, ALEXIS ELISE (PHDHP, RDH)
Entity type:Individual
Prefix:MISS
First Name:ALEXIS
Middle Name:ELISE
Last Name:PASSARELLI
Suffix:
Gender:
Credentials:PHDHP, RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:451 CIRCLE RD
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-4119
Mailing Address - Country:US
Mailing Address - Phone:814-880-0981
Mailing Address - Fax:
Practice Address - Street 1:451 CIRCLE RD
Practice Address - Street 2:
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-4119
Practice Address - Country:US
Practice Address - Phone:814-880-0981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-07
Last Update Date:2025-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0402209130124Q00000X
MD8959124Q00000X
NY032691124Q00000X
NJ22HI01261100124Q00000X
PADH073981124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist