Provider Demographics
NPI:1740646827
Name:CHAMBERLAND, SHIRLEY SUKHANIL (DDS)
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:SUKHANIL
Last Name:CHAMBERLAND
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 1:24792 OXFORD DR
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-8871
Mailing Address - Country:US
Mailing Address - Phone:949-412-2156
Mailing Address - Fax:
Practice Address - Street 1:24792 OXFORD DR
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-8871
Practice Address - Country:US
Practice Address - Phone:949-412-2156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA47323122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist