Provider Demographics
NPI:1891143061
Name:LUPER, ALEXANDRIA STONE (DMD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDRIA
Middle Name:STONE
Last Name:LUPER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 NASH ST N
Mailing Address - Street 2:
Mailing Address - City:WILSON
Mailing Address - State:NC
Mailing Address - Zip Code:27893-2364
Mailing Address - Country:US
Mailing Address - Phone:252-237-3117
Mailing Address - Fax:
Practice Address - Street 1:1310 NASH ST N
Practice Address - Street 2:
Practice Address - City:WILSON
Practice Address - State:NC
Practice Address - Zip Code:27893-2364
Practice Address - Country:US
Practice Address - Phone:252-237-3117
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-28
Last Update Date:2019-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC103921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice