Provider Demographics
NPI:1730879032
Name:PLUCINSKY, ALEXIS MARIE (DMD)
Entity type:Individual
Prefix:DR
First Name:ALEXIS
Middle Name:MARIE
Last Name:PLUCINSKY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:DR
Other - First Name:LEXI
Other - Middle Name:MARIE
Other - Last Name:PLUCINSKY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DMD
Mailing Address - Street 1:7249 WINCHESTER DR
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-4819
Mailing Address - Country:US
Mailing Address - Phone:440-289-1554
Mailing Address - Fax:
Practice Address - Street 1:1611 S GREEN RD STE 157
Practice Address - Street 2:
Practice Address - City:SOUTH EUCLID
Practice Address - State:OH
Practice Address - Zip Code:44121-4122
Practice Address - Country:US
Practice Address - Phone:216-381-6521
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-10
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0271501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice