Healthcare Provider Details

I. General information

NPI: 1871116673
Provider Name (Legal Business Name): CHELSEA ANN GRIEBE DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2020
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36600 HERITAGE DR
RICHMOND MI
48062-1937
US

IV. Provider business mailing address

36600 HERITAGE DR
RICHMOND MI
48062-1937
US

V. Phone/Fax

Practice location:
  • Phone: 586-727-3815
  • Fax:
Mailing address:
  • Phone: 586-321-7751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number12013351A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2901600868
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: