IndividualActive
Carlos Ibanez, DDS
NPI 1154327005 · Oral and Maxillofacial Surgery (Dentist) · Charlottesville, VA
Provider details
- NPI number
- 1154327005
- Entity type
- Individual
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
- License
- 0401412224 (VA)
Practice location
1415 Rolkin Court
Suite 101
Charlottesville, VA 22911
Phone: (434) 295-0911
Fax: (434) 295-4139
Mailing address
1415 Rolkin Court
Charlottesville, VA 22911
Registry dates
- Enumerated
- 2005-06-24
- Last updated
- 2018-10-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.