=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922498070
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ARWA ALWEHAIB DDS
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/28/2015
-----------------------------------------------------
Last Update Date | 01/28/2015
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 600 S DIXIE HWY SUIT 105
-----------------------------------------------------
City | WEST PALM BEACH
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33401-5824
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-446-5390
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 643 VISTA ISLES DR APT 1811
-----------------------------------------------------
City | PLANTATION
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 33325-6129
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 954-446-5390
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1223G0001X
-----------------------------------------------------
Taxonomy Name | General Practice Dentistry
-----------------------------------------------------
License Number | 20993
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------