Provider Demographics
NPI:1619997681
Name:ARNOLD, SCOTT D (DMD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:D
Last Name:ARNOLD
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:257 W BRANDON BLVD
Mailing Address - Street 2:
Mailing Address - City:BRANDON
Mailing Address - State:FL
Mailing Address - Zip Code:33511-5103
Mailing Address - Country:US
Mailing Address - Phone:813-689-1529
Mailing Address - Fax:813-684-8595
Practice Address - Street 1:257 W BRANDON BLVD
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:FL
Practice Address - Zip Code:33511-5103
Practice Address - Country:US
Practice Address - Phone:813-689-1529
Practice Address - Fax:813-684-8595
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2023-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN142551223S0112X, 122400000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122400000XDental ProvidersDenturist
No1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
No1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL200523867OtherTIN