Provider Demographics
NPI:1891214698
Name:THOMAS, CHESSIA (DMD)
Entity Type:Individual
Prefix:
First Name:CHESSIA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1286 E WEST HWY
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3242
Mailing Address - Country:US
Mailing Address - Phone:301-761-4489
Mailing Address - Fax:
Practice Address - Street 1:1286 E WEST HWY
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20910-3242
Practice Address - Country:US
Practice Address - Phone:301-761-4489
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-12
Last Update Date:2021-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0098701223G0001X
MD172181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice