Healthcare Provider Details

I. General information

NPI: 1427332147
Provider Name (Legal Business Name): SHIJIA HU B.D.S
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2011
Last Update Date: 09/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 BRAUER HALL MANNING DRIVE AND COLUMBIA ST UNC SCHOOL OF DENTISTRY CAMPUS BOX 7450
CHAPEL HILL NC
27599-7450
US

IV. Provider business mailing address

228 BRAUER HALL MANNING DRIVE AND COLUMBIA ST UNC SCHOOL OF DENTISTRY CAMPUS BOX 7450
CHAPEL HILL NC
27599-7450
US

V. Phone/Fax

Practice location:
  • Phone: 919-966-2743
  • Fax: 919-966-7992
Mailing address:
  • Phone: 919-966-2743
  • Fax: 919-966-7992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number150866
License Number StateNC

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: