Chelsea Lynn Jackson
Dentist in Anthem, AZ. Individual provider (NPI-1).
NPI number1235786013
StatusActive
Last updated in NPPESNov 15, 2021
Details
- NPI
- 1235786013
- Entity type
- Individual (NPI-1)
- Name
- Chelsea Lynn Jackson
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 26, 2019
- Certification date
- Nov 15, 2021
- Last updated
- Nov 15, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | D010374 | AZ | Yes |
| 122300000X | Dentist | 30.025964 | OH |
Practice location
42201 N 41st Dr Ste 156Anthem, AZ 85086-3803
Phone 623-551-3511
Mailing address
2234 W Webster CtAnthem, AZ 85086-1854
Phone 602-405-5998
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