Healthcare Provider Details

I. General information

NPI: 1285127035
Provider Name (Legal Business Name): CHELSEY L ALLEN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2018
Last Update Date: 06/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34225 N 27TH DR STE 240
PHOENIX AZ
85085-6091
US

IV. Provider business mailing address

6181 W PARK AVE
CHANDLER AZ
85226-1195
US

V. Phone/Fax

Practice location:
  • Phone: 623-322-1538
  • Fax:
Mailing address:
  • Phone: 480-516-1557
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD010033
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberD010033
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: