MEDICARE: DR. J. FREDERICK CHAIRSELL 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	1223P0106X	Oral and Maxillofacial Pathology Dentistry	DS018475L	PA
2	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	DS018475L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	32271	OTHER	PA	BLUE SHIELD ID NUMBER
2	231944530	OTHER	PA	TAX ID
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1588634877
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. J. FREDERICK CHAIRSELL DDS

Provider Business Mailing Address
First Line	:	190 GOOD DR
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17603-2353
Country	:	US
Telephone Number	:	717-394-3033
Fax Number	:	717-390-2641

Provider Business Practice Location Address
First Line	:	190 GOOD DR
Second Line	:
City	:	LANCASTER
State	:	PA
Zip	:	17603-2353
Country	:	US
Telephone Number	:	717-394-3033
Fax Number	:	717-390-2641

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

Provider Enumeration Date	:	01/26/2006
Last Update Date	:	08/02/2011

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Directions to “ DR. J. FREDERICK CHAIRSELL DDS” Practice Location

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