Healthcare Provider Details

I. General information

NPI: 1124654124
Provider Name (Legal Business Name): CHELSEA ANN STRAUGHN DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/21/2020
Last Update Date: 03/06/2025
Certification Date: 03/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 E MONROE AVE
ALEXANDRIA VA
22301-3020
US

IV. Provider business mailing address

4613 KIRKLAND PL
ALEXANDRIA VA
22311-4961
US

V. Phone/Fax

Practice location:
  • Phone: 703-307-9533
  • Fax:
Mailing address:
  • Phone: 703-307-9533
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number0401418590
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: