Healthcare Provider Details

I. General information

NPI: 1710360748
Provider Name (Legal Business Name): SEAN CHAPMAN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2015
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1024 COLINGTON RD
KILL DEVIL HILLS NC
27948-8019
US

IV. Provider business mailing address

1024 COLINGTON RD
KILL DEVIL HILLS NC
27948-8019
US

V. Phone/Fax

Practice location:
  • Phone: 252-441-8882
  • Fax:
Mailing address:
  • Phone: 252-441-8882
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number9438616
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: