Provider Demographics
NPI:1871358937
Name:BENNAIM, ALEXA (RDH)
Entity type:Individual
Prefix:MRS
First Name:ALEXA
Middle Name:
Last Name:BENNAIM
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:341 SALINGER PL
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-4760
Mailing Address - Country:US
Mailing Address - Phone:240-620-5905
Mailing Address - Fax:
Practice Address - Street 1:341 SALINGER PL
Practice Address - Street 2:
Practice Address - City:GAITHERSBURG
Practice Address - State:MD
Practice Address - Zip Code:20878-4760
Practice Address - Country:US
Practice Address - Phone:240-620-5905
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-19
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD8561124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist