Provider Demographics
NPI:1407694763
Name:WORKMAN, CHELSEA RAE
Entity type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:RAE
Last Name:WORKMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4815 BEREWICK TOWN CENTER DR STE J
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-6733
Mailing Address - Country:US
Mailing Address - Phone:704-800-0252
Mailing Address - Fax:
Practice Address - Street 1:4815 BEREWICK TOWN CENTER DR STE J
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28278-6733
Practice Address - Country:US
Practice Address - Phone:704-800-0252
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-19
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10936122300000X
NC138281223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist