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General NPI Number Information
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NPI Number | 1992150247
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Entity Type | Individual
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Provider Name | CHRESTENE BIBAWY D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 04/24/2016
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Last Update Date | 11/30/2022
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Provider Practice Location Address
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Address Line | 3101 EDWARDS MILL RD
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City | RALEIGH
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State | NC
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Zip | 27612-5303
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Country | US
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Telephone | 919-571-0222
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Fax |
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Provider Business Mailing Address
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Address Line | 1019 COMMACK DR
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City | DURHAM
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State | NC
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Zip | 27703-6771
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Country | US
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Telephone | 646-258-6357
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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 | 13065
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 22DI02689400
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License Number State | NJ
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 059361
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License Number State | NY
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