Healthcare Provider Details

I. General information

NPI: 1467360560
Provider Name (Legal Business Name): CHUYAO XU
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3500 N DUKE ST
DURHAM NC
27704-1707
US

IV. Provider business mailing address

941 ATHLETIC LN APT 306
MORRISVILLE NC
27560-9083
US

V. Phone/Fax

Practice location:
  • Phone: 984-439-1685
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number14828
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: