1801454814 NPI number — STEPHANIE R. ARREDONDO-GLACET DMD

Table of content: STEPHANIE R. ARREDONDO-GLACET DMD (NPI 1801454814)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1801454814 NPI number — STEPHANIE R. ARREDONDO-GLACET DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARREDONDO-GLACET
Provider First Name:
STEPHANIE
Provider Middle Name:
R.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ARREDONDO
Provider Other First Name:
STEPHANIE
Provider Other Middle Name:
R.
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DMD
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1801454814
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/20/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14057 US HIGHWAY 17 STE 120
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAMPSTEAD
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28443-3771
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
910-270-9344
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14057 US HIGHWAY 17 STE 120
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAMPSTEAD
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28443-3771
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
910-270-9344
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/04/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  13573 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2026 www.npivalidator.com