Healthcare Provider Details

I. General information

NPI: 1558624569
Provider Name (Legal Business Name): ARWA ABUALSOUD D.M.D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2012
Last Update Date: 08/23/2026
Certification Date: 08/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2317 REMINGTON WAY
LEXINGTON KY
40511-9236
US

IV. Provider business mailing address

4173 BRIDGEMONT LN
LEXINGTON KY
40515-6006
US

V. Phone/Fax

Practice location:
  • Phone: 859-605-5173
  • Fax:
Mailing address:
  • Phone: 859-806-4361
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number17643
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: