Provider Demographics
NPI:1255171930
Name:PERES, ALEXA (DDS)
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:
Last Name:PERES
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 1:305 CURRY AVE
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48067-1907
Mailing Address - Country:US
Mailing Address - Phone:248-979-7191
Mailing Address - Fax:
Practice Address - Street 1:8091 COMMERCE RD STE 3
Practice Address - Street 2:
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48382-3575
Practice Address - Country:US
Practice Address - Phone:248-242-6600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-29
Last Update Date:2025-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5315260390122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist