Provider Demographics
NPI:1760020614
Name:DRAGOJEVIC, ALEKSANDRA (DDS)
Entity type:Individual
Prefix:
First Name:ALEKSANDRA
Middle Name:
Last Name:DRAGOJEVIC
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 1:110 SAN ANTONIO ST APT 705
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78701-0031
Mailing Address - Country:US
Mailing Address - Phone:917-797-8762
Mailing Address - Fax:
Practice Address - Street 1:250A HWY 290 E
Practice Address - Street 2:ATTN LSPD & BRACES
Practice Address - City:ELGIN
Practice Address - State:TX
Practice Address - Zip Code:78621
Practice Address - Country:US
Practice Address - Phone:512-285-9868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-11
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY061733122300000X
TX387511223P0221X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No122300000XDental ProvidersDentist
Yes1223P0221XDental ProvidersDentistPediatric Dentistry