MEDICARE: CHELSIE LO DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	D012197	AZ
2	390200000X	Student in an Organized Health Care Education/Training Program		AZ
3	122300000X	Dentist	D012197	AZ

General Provider Information

NPI Number	:	1447092580
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHELSIE LO DMD

Provider Business Mailing Address
First Line	:	2269 W ECHO LN
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85021-4285
Country	:	US
Telephone Number	:	510-283-8659
Fax Number	:

Provider Business Practice Location Address
First Line	:	25155 N 67TH AVE STE 142
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85083-1065
Country	:	US
Telephone Number	:	623-561-6767
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2024
Last Update Date	:	06/12/2024

Similar Medicare Providers

1649107731 — KYLE FILICETTI
Practice Location Address:

25155 N 67TH AVE STE 142
PHOENIX, AZ
85083-1065

Practice Phone: 623-561-6767
Practice Fax:

1194048744 — CANYON VISTA DENTISTRY AND ORTHODONTICS,LLP
Practice Location Address:

25155 N 67TH AVE STE 142
PHOENIX, AZ
85083-1065

Practice Phone: 626-561-6767
Practice Fax: 623-561-1703

1972081305 — DR. HARSHVIR KAUR AUJLA DDS
Practice Location Address:

25155 N 67TH AVE STE 142
PHOENIX, AZ
85083-1065

Practice Phone: 623-561-6767
Practice Fax:

1396420360 — DR. CRISTEN NICOLE PHILLIPS DMD
Practice Location Address:

25155 N 67TH AVE STE 142
PHOENIX, AZ
85083-1065

Practice Phone: 623-561-6767
Practice Fax:

1336547405 — ISAAC HORTON
Practice Location Address:

5010 E CHEYENNE DR , #1065
PHOENIX, AZ
85044-1770

Practice Phone: 470-333-8938
Practice Fax:

1023484482 — MARTHA SOFIA HORTON R.N
Practice Location Address:

13612 S 36TH ST , APT. #1065
PHOENIX, AZ
85044-4544

Practice Phone: 480-541-2600
Practice Fax:

Directions to “ CHELSIE LO DMD” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.