Provider Demographics
NPI:1023199411
Name:CHAMBERS, SAMUEL HERIGES (DMD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:HERIGES
Last Name:CHAMBERS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 ROCKBRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:VA
Mailing Address - Zip Code:23707-2309
Mailing Address - Country:US
Mailing Address - Phone:205-966-3168
Mailing Address - Fax:
Practice Address - Street 1:USS TRENTON
Practice Address - Street 2:FPO/AE 09588-1719
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23707
Practice Address - Country:US
Practice Address - Phone:757-444-1450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL5374122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist