Healthcare Provider Details

I. General information

NPI: 1679497408
Provider Name (Legal Business Name): MISS SARA AL HABAHBEH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 S COLUMBIA ST
CHAPEL HILL NC
27514-4309
US

IV. Provider business mailing address

385 S COLUMBIA ST CB 7450
CHAPEL HILL NC
27514-4309
US

V. Phone/Fax

Practice location:
  • Phone: 919-537-3832
  • Fax: 919-537-3589
Mailing address:
  • Phone: 919-537-3832
  • Fax: 919-537-3589

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number151552
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: