Provider Demographics
NPI:1598059578
Name:CHIAVETTA, REBEKAH SPARROW (DDS)
Entity Type:Individual
Prefix:DR
First Name:REBEKAH
Middle Name:SPARROW
Last Name:CHIAVETTA
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2221 WHITMAN RD
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27607-6648
Mailing Address - Country:US
Mailing Address - Phone:919-787-9747
Mailing Address - Fax:
Practice Address - Street 1:2221 WHITMAN RD
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27607-6648
Practice Address - Country:US
Practice Address - Phone:919-787-9747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC71171223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice