Provider Demographics
NPI:1699089607
Name:BERNSTEIN, CHELSEA SUZANNE (DDS)
Entity type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:SUZANNE
Last Name:BERNSTEIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:CHELSEA
Other - Middle Name:SUZANNE
Other - Last Name:BERNSTEIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7930 WYOMING BLVD NE
Mailing Address - Street 2:SUITE C
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109
Mailing Address - Country:US
Mailing Address - Phone:505-828-2020
Mailing Address - Fax:505-828-0281
Practice Address - Street 1:7930 WYOMING BLVD NE
Practice Address - Street 2:SUITE C
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109
Practice Address - Country:US
Practice Address - Phone:505-828-2020
Practice Address - Fax:505-828-0281
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-02
Last Update Date:2019-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD33601223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM850318795OtherDENTAL INSURANCE