Healthcare Provider Details

I. General information

NPI: 1033992599
Provider Name (Legal Business Name): ALLA ALEXIS SHRAGER DMD 4 PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/17/2023
Last Update Date: 01/13/2025
Certification Date: 01/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8331 BANDFORD WAY STE 105
RALEIGH NC
27615-2765
US

IV. Provider business mailing address

8331 BANDFORD WAY STE 105
RALEIGH NC
27615-2765
US

V. Phone/Fax

Practice location:
  • Phone: 919-636-5200
  • Fax:
Mailing address:
  • Phone: 919-636-5200
  • Fax: 919-847-7391

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: DR. ALLA ALLA SHRAGER
Title or Position: PRESIDENT
Credential: DMD
Phone: 412-720-9277