Provider Demographics
NPI:1467837278
Name:BENZA, CHELSEA ANN YANDA (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:ANN YANDA
Last Name:BENZA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:ANN
Other - Last Name:YANDA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:9140 GALLERIA CT
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34109-4343
Mailing Address - Country:US
Mailing Address - Phone:239-592-5112
Mailing Address - Fax:239-592-0254
Practice Address - Street 1:9140 GALLERIA CT
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34109-4343
Practice Address - Country:US
Practice Address - Phone:239-592-5112
Practice Address - Fax:239-592-0254
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-22
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-024583122300000X
FLDN 215461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist