=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487644191
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALEXANDER ARBELO DMD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/24/2005
-----------------------------------------------------
Last Update Date | 12/19/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2831 MIDWAY RD SE STE 116
-----------------------------------------------------
City | BOLIVIA
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28422-8377
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-408-4436
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1288 BUCKLAND ROW
-----------------------------------------------------
City | LELAND
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28451-2247
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 570-637-3146
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 12587
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 122300000X
-----------------------------------------------------
Taxonomy Name | Dentist
-----------------------------------------------------
License Number | 052407
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------