Provider Demographics
NPI:1881027084
Name:BALDERSON, CHELSEA LYNN (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:LYNN
Last Name:BALDERSON
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 1:7389 LEE HWY STE 101
Mailing Address - Street 2:
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22042-1737
Mailing Address - Country:US
Mailing Address - Phone:703-468-4437
Mailing Address - Fax:703-876-4705
Practice Address - Street 1:7389 LEE HWY STE 101
Practice Address - Street 2:
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22042-1737
Practice Address - Country:US
Practice Address - Phone:703-468-4437
Practice Address - Fax:703-876-4705
Is Sole Proprietor?:No
Enumeration Date:2013-08-12
Last Update Date:2015-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401414832122300000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program