Provider Demographics
NPI:1851281745
Name:LEVINES, ALEXANDREA GRACE (DMD)
Entity type:Individual
Prefix:
First Name:ALEXANDREA
Middle Name:GRACE
Last Name:LEVINES
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 RIVER BIRCH RD
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:SC
Mailing Address - Zip Code:29670-1881
Mailing Address - Country:US
Mailing Address - Phone:706-612-5201
Mailing Address - Fax:
Practice Address - Street 1:5075 CALHOUN MEMORIAL HWY
Practice Address - Street 2:
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-3837
Practice Address - Country:US
Practice Address - Phone:864-442-5448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC111751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice