Healthcare Provider Details

I. General information

NPI: 1295221216
Provider Name (Legal Business Name): ABIGAIL W SCANLAN DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/02/2018
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11420 FALLS OF NEUSE RD
RALEIGH NC
27614-9305
US

IV. Provider business mailing address

11420 FALLS OF NEUSE RD
RALEIGH NC
27614-9305
US

V. Phone/Fax

Practice location:
  • Phone: 919-977-1870
  • Fax: 919-977-1872
Mailing address:
  • Phone: 914-484-1956
  • Fax: 919-919-1872

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number11106
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number11106
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: