Alla Alexis Shrager DMD 4 PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

ALLA ALEXIS SHRAGER DMD 4 PLLC

Doing business as

Lake Gaston Dental - Warrenton

Practice address

8331 Bandford Way Ste 105
Raleigh, NC 27615-2765

Phone

(919) 636-5200

NPI assigned

Aug 17, 2023

Last updated

Jan 13, 2025By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Alla Alla Shrager, DMDNPI 1215128343

Title

President

Phone

(412) 720-9277

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 2

• Lake Gaston Dental - Warrenton Doing business as
• Southern Dental Group Other name

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Alla Alexis Shrager DMD 3 PA

  dba Lake Gaston Dental

  • Public Health Dentistry
  • Warrenton, NC
  • NPI 1346050622
  NPPES parent name

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alla Alexis Shrager, DMD

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Raleigh, NC
  • NPI 1215128343
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1692230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1736726400000",
    "number": "1033992599",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8331 BANDFORD WAY STE 105",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276152765",
            "telephone_number": "919-636-5200",
            "fax_number": "919-847-7391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8331 BANDFORD WAY STE 105",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276152765",
            "telephone_number": "919-636-5200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "136 E South Main Street",
            "address_purpose": "LOCATION",
            "city": "Littleton",
            "state": "NC",
            "postal_code": "27850",
            "country_code": "US",
            "telephone_number": "252-586-4059",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "30 S Dunn Street",
            "address_purpose": "LOCATION",
            "city": "Angier",
            "state": "NC",
            "postal_code": "27501",
            "country_code": "US",
            "telephone_number": "919-636-5200",
            "fax_number": "919-847-7391",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12470 Spruce Tree Way",
            "address_2": "100",
            "address_purpose": "LOCATION",
            "city": "Raleigh",
            "state": "NC",
            "postal_code": "27615",
            "country_code": "US",
            "telephone_number": "919-636-5200",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "202 Graham St",
            "address_purpose": "LOCATION",
            "city": "Warrenton",
            "state": "NC",
            "postal_code": "275891912",
            "country_code": "US",
            "telephone_number": "252-257-3736",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ALLA ALEXIS SHRAGER DMD 4 PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-08-17",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-08",
        "status": "A",
        "authorized_official_last_name": "SHRAGER",
        "authorized_official_first_name": "ALLA",
        "authorized_official_middle_name": "ALLA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "412-720-9277",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL",
            "identifier": "12355",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lake Gaston Dental - Warrenton",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Dental Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Dental Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Dental Group",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• General Practice Dentistry in Raleigh, NC
• Providers in Raleigh, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.