Provider Demographics
NPI:1710548649
Name:LEW, ALEXANDER MARCUS (DDS)
Entity type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:MARCUS
Last Name:LEW
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:38 WILLARD LN
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:CA
Mailing Address - Zip Code:94010-7048
Mailing Address - Country:US
Mailing Address - Phone:650-520-6036
Mailing Address - Fax:
Practice Address - Street 1:809 CUESTA DR STE 205
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-3666
Practice Address - Country:US
Practice Address - Phone:650-399-9657
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-21
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1053651223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice