Provider Demographics
NPI:1033579388
Name:ELSON, CHELSEA LYNNAE (RDH)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:LYNNAE
Last Name:ELSON
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15555 E 40TH AVE UNIT 88
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80239-5756
Mailing Address - Country:US
Mailing Address - Phone:303-503-1137
Mailing Address - Fax:
Practice Address - Street 1:15555 E 40TH AVE UNIT 88
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80239-5756
Practice Address - Country:US
Practice Address - Phone:303-503-1137
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-29
Last Update Date:2016-02-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO002024365124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist