Healthcare Provider Details

I. General information

NPI: 1144675422
Provider Name (Legal Business Name): ALBERT RAY NEWSOME III DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2016
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

901 N LINDSAY ST
HIGH POINT NC
27262-3903
US

IV. Provider business mailing address

901 N LINDSAY ST
HIGH POINT NC
27262-3903
US

V. Phone/Fax

Practice location:
  • Phone: 336-884-8771
  • Fax:
Mailing address:
  • Phone: 336-884-8771
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number12176
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code204E00000X
TaxonomyOral & Maxillofacial Surgery (D.M.D.)
License Number12176
License Number StateNC
# 3
Primary TaxonomyN
Taxonomy Code1223P0106X
TaxonomyOral and Maxillofacial Pathology Dentistry
License Number12176
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: