Provider Demographics
NPI:1619296019
Name:KUIPERS, CHELSEA RENEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:RENEE
Last Name:KUIPERS
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 1:720 N SYCAMORE AVE
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57110-5740
Mailing Address - Country:US
Mailing Address - Phone:605-338-6118
Mailing Address - Fax:605-335-4798
Practice Address - Street 1:720 N SYCAMORE AVE
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57110-5740
Practice Address - Country:US
Practice Address - Phone:605-338-6118
Practice Address - Fax:605-335-4798
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDDO936122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist