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General NPI Number Information
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NPI Number | 1124387667
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Entity Type | Individual
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Provider Name | CARLESHA JANEE CHAMBERS DDS
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Gender | Female
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Dates
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Enumeration Date | 05/03/2012
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Last Update Date | 06/09/2014
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Provider Practice Location Address
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Address Line | 9275 DOERR RD STE 1400 HQ, NORTHERN REGIONAL DENTAL COMMAND (ATTN CREDENTIALS)
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City | FORT BELVOIR
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State | VA
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Zip | 22060-2204
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Country | US
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Telephone | 571-231-5383
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Fax |
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Provider Business Mailing Address
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Address Line | 9275 DOERR RD STE 1400 HQ, NORTHERN REGIONAL DENTAL COMMAND (ATTN CREDENTIALS)
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City | FORT BELVOIR
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State | VA
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Zip | 22060-2204
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Country | US
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Telephone | 571-231-5383
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 30.023468
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License Number State | OH
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