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General NPI Number Information
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NPI Number | 1336700327
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Entity Type | Individual
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Provider Name | CHELSEA DIAMOND DMD
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Gender | Female
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Dates
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Enumeration Date | 06/21/2019
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Last Update Date | 05/24/2023
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Provider Practice Location Address
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Address Line | 135 W JERICHO TPKE
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-3649
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Country | US
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Telephone | 631-424-5900
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Fax |
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Provider Business Mailing Address
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Address Line | 135 W JERICHO TPKE
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City | HUNTINGTON STATION
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State | NY
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Zip | 11746-3649
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Country | US
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Telephone | 631-424-5900
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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 | 35158
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 062329
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License Number State | NY
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