Healthcare Provider Details

I. General information

NPI: 1265353320
Provider Name (Legal Business Name): MELEUH FOBELLAH D.D.S.
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 S POST RD
SHELBY NC
28152-6269
US

IV. Provider business mailing address

200 S POST RD
SHELBY NC
28152-6269
US

V. Phone/Fax

Practice location:
  • Phone: 980-484-5100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14914
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: