Provider Demographics
NPI:1487703708
Name:CONSTANTINESCU, ALECSANDRA (DDS)
Entity type:Individual
Prefix:DR
First Name:ALECSANDRA
Middle Name:
Last Name:CONSTANTINESCU
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:432 N 6TH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19123-4004
Mailing Address - Country:US
Mailing Address - Phone:215-925-2400
Mailing Address - Fax:215-925-9162
Practice Address - Street 1:640 SNYDER AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19148-2419
Practice Address - Country:US
Practice Address - Phone:215-334-4900
Practice Address - Fax:215-334-9721
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS036358122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
000000292506OtherDENTAL BENEFIT PROVIDERS
9181870OtherDORAL DENTAL USA
PA101553493Medicaid