Provider Demographics
NPI:1194611764
Name:KORNMEHL, CHELSEA (DMD)
Entity type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:
Last Name:KORNMEHL
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14396 WASHINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44118-4677
Mailing Address - Country:US
Mailing Address - Phone:732-610-5106
Mailing Address - Fax:
Practice Address - Street 1:14396 WASHINGTON BLVD
Practice Address - Street 2:
Practice Address - City:UNIVERSITY HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44118-4677
Practice Address - Country:US
Practice Address - Phone:732-610-5106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-17
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30.0280951223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice