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General NPI Number Information
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NPI Number | 1043915150
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Entity Type | Individual
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Provider Name | CHRISELLE BARITUA TIU
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Gender | Female
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Dates
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Enumeration Date | 03/31/2023
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 582 KANNAPOLIS PKWY
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City | KANNAPOLIS
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State | NC
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Zip | 28027-8215
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Country | US
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Telephone | 704-273-5020
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Fax |
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Provider Business Mailing Address
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Address Line | 8225 PINEVILLE MATTHEWS RD APT A
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City | CHARLOTTE
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State | NC
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Zip | 28226-4735
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Country | US
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Telephone | 386-546-6810
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 13752
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 10751
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License Number State | SC
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