Healthcare Provider Details

I. General information

NPI: 1831258920
Provider Name (Legal Business Name): KAREN K. TIWANA DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/06/2006
Last Update Date: 09/26/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

587 OLD GRAHAM RD
PITTSBORO NC
27312
US

IV. Provider business mailing address

587 OLD GRAHAM RD PO BOX 582
PITTSBORO NC
27312
US

V. Phone/Fax

Practice location:
  • Phone: 919-542-4911
  • Fax: 919-542-5714
Mailing address:
  • Phone: 919-542-4911
  • Fax: 919-542-5714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number9661
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: