MEDICARE: DR. CHYNA WIMBERLY DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	14431	NC

General Provider Information

NPI Number	:	1861377525
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHYNA WIMBERLY DDS

Provider Business Mailing Address
First Line	:	8104 HAIDAS AVE
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28214-0214
Country	:	US
Telephone Number	:	757-323-3338
Fax Number	:

Provider Business Practice Location Address
First Line	:	1917 HOFFMAN RD
Second Line	:
City	:	GASTONIA
State	:	NC
Zip	:	28054-6574
Country	:	US
Telephone Number	:	980-289-0447
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/11/2025
Last Update Date	:	03/30/2026

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