Healthcare Provider Details

I. General information

NPI: 1487567947
Provider Name (Legal Business Name): ISAAC EDWARDS DDS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1203 RIDGE RD
RALEIGH NC
27607-6834
US

IV. Provider business mailing address

1016 SCHAUB DR
RALEIGH NC
27606-1804
US

V. Phone/Fax

Practice location:
  • Phone: 919-818-6698
  • Fax:
Mailing address:
  • Phone: 919-818-6698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ISAAC JARED EDWARDS
Title or Position: OWNER/DENTIST
Credential: DDS
Phone: 919-818-6698