Healthcare Provider Details

I. General information

NPI: 1487644191
Provider Name (Legal Business Name): ALEXANDER ARBELO DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2831 MIDWAY RD SE STE 116
BOLIVIA NC
28422-8377
US

IV. Provider business mailing address

1288 BUCKLAND ROW
LELAND NC
28451-2247
US

V. Phone/Fax

Practice location:
  • Phone: 910-408-4436
  • Fax:
Mailing address:
  • Phone: 570-637-3146
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number12587
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number052407
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: