Provider Demographics
NPI:1235796657
Name:REIS, CHELSEA FAYE (DDS)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:FAYE
Last Name:REIS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:FAYE
Other - Last Name:REIS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1631 PAMELA LN
Mailing Address - Street 2:
Mailing Address - City:MENDOTA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55118-3738
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1011 BEL AIR LN NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-6992
Practice Address - Country:US
Practice Address - Phone:507-288-1188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-21
Last Update Date:2019-07-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND14202122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist