Provider Demographics
NPI:1568623387
Name:CHELSEA DENTAL OFFICE PLLC
Entity Type:Organization
Organization Name:CHELSEA DENTAL OFFICE PLLC
Other - Org Name:CHELSEA DENTAL OFFICE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJ
Authorized Official - Middle Name:KUMAR
Authorized Official - Last Name:SINGLA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:212-675-2044
Mailing Address - Street 1:235 W 14TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-7102
Mailing Address - Country:US
Mailing Address - Phone:212-675-2044
Mailing Address - Fax:212-675-0482
Practice Address - Street 1:235 W 14TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-7102
Practice Address - Country:US
Practice Address - Phone:212-675-2044
Practice Address - Fax:212-675-0482
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-24
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037414122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00787673Medicaid