Provider Demographics
NPI:1952285629
Name:IZAGUIRRE, ALEXANDRA ELIZABETH (DMD)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:ELIZABETH
Last Name:IZAGUIRRE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5336 RAINTREE TRL
Mailing Address - Street 2:
Mailing Address - City:OAKWOOD
Mailing Address - State:GA
Mailing Address - Zip Code:30566-3044
Mailing Address - Country:US
Mailing Address - Phone:864-603-0565
Mailing Address - Fax:
Practice Address - Street 1:2888 BROWNS BRIDGE RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30504-5657
Practice Address - Country:US
Practice Address - Phone:770-532-1111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-04
Last Update Date:2025-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN123905122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist