Provider Demographics
NPI:1386984391
Name:CALLAWAY, CHIMERE R (DDS)
Entity type:Individual
Prefix:DR
First Name:CHIMERE
Middle Name:R
Last Name:CALLAWAY
Suffix:
Gender:
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:236 MARKET ST STE 200
Mailing Address - Street 2:
Mailing Address - City:LOCUST
Mailing Address - State:NC
Mailing Address - Zip Code:28097-9439
Mailing Address - Country:US
Mailing Address - Phone:980-354-8154
Mailing Address - Fax:
Practice Address - Street 1:236 MARKET ST STE 200
Practice Address - Street 2:
Practice Address - City:LOCUST
Practice Address - State:NC
Practice Address - Zip Code:28097-9439
Practice Address - Country:US
Practice Address - Phone:980-354-8154
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-28
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC108551223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry