Active NPI
Chrestene Bibawy, D.D.S.
- General Practice Dentistry
- Raleigh, NC
National Provider Identifier
1992150247
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 059361
- Practice address
- 3101 Edwards Mill Rd
Raleigh, NC 27612-5303 - Phone
- (919) 571-0222
- NPI assigned
- Apr 24, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 13065 | NC | |
| General Practice Dentistry | 1223G0001X | 22DI02689400 | NJ | |
| General Practice Dentistry | 1223G0001X | 059361 | NY | Primary |
Addresses
Primary practice location
3101 Edwards Mill Rd
Raleigh, NC 27612-5303
Mailing address
1019 Commack Dr
Durham, NC 27703-6771
Phone (646) 258-6357
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13065 | NC | MD | Dentist |
| 22DI02689400 | NJ | MD | General Practice Dentistry |
| 059361 | NY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| JDS Dental Care PLLC | Dentist | Past | Accepting new patients |
| Jack Miceli DDS PC | General Practice | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
dba Marine Dental Services
- General Practice Dentistry
- Staten Island, NY
- NPI 1932266566
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669766400000",
"number": "1992150247",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1019 COMMACK DR",
"city": "DURHAM",
"state": "NC",
"postal_code": "277036771",
"telephone_number": "646-258-6357"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3101 EDWARDS MILL RD",
"city": "RALEIGH",
"state": "NC",
"postal_code": "276125303",
"telephone_number": "919-571-0222"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BIBAWY",
"first_name": "CHRESTENE",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-04-24",
"last_updated": "2022-11-30",
"certification_date": "2022-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NC",
"license": "13065",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NJ",
"license": "22DI02689400",
"primary": false
},
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NY",
"license": "059361",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Raleigh, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.