Provider Demographics
NPI:1376827444
Name:CHASOLEN, GINGER ROBIN (DDS)
Entity Type:Individual
Prefix:DR
First Name:GINGER
Middle Name:ROBIN
Last Name:CHASOLEN
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 1:1215 S EAST AVE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34239-2342
Mailing Address - Country:US
Mailing Address - Phone:941-955-8887
Mailing Address - Fax:941-955-8444
Practice Address - Street 1:1215 S EAST AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-2342
Practice Address - Country:US
Practice Address - Phone:941-955-8887
Practice Address - Fax:941-955-8444
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-06
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN 00137351223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics