Provider Demographics
NPI:1366060907
Name:MCANENEY, ALEXA NOELLE (DMD)
Entity type:Individual
Prefix:DR
First Name:ALEXA
Middle Name:NOELLE
Last Name:MCANENEY
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 1:65 E 10600 S STE 104
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84070-4124
Mailing Address - Country:US
Mailing Address - Phone:801-305-3736
Mailing Address - Fax:
Practice Address - Street 1:65 E 10600 S
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-4124
Practice Address - Country:US
Practice Address - Phone:801-305-3736
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-09
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT12991815-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice