Provider Demographics
NPI:1225699507
Name:HOOPER, CHELSEA (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:
Last Name:HOOPER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 4043
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75106-4043
Mailing Address - Country:US
Mailing Address - Phone:469-323-5549
Mailing Address - Fax:
Practice Address - Street 1:5925 CONVAIR DR
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76109-1275
Practice Address - Country:US
Practice Address - Phone:817-778-0418
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-26
Last Update Date:2020-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX352231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice