Provider Demographics
NPI:1982048971
Name:PINTO, CHELSEA (BS, DDS)
Entity Type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:
Last Name:PINTO
Suffix:
Gender:F
Credentials:BS, DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4123 CHASE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90066-5733
Mailing Address - Country:US
Mailing Address - Phone:317-440-5940
Mailing Address - Fax:
Practice Address - Street 1:4123 CHASE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90066-5733
Practice Address - Country:US
Practice Address - Phone:317-440-5940
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-22
Last Update Date:2015-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA63688122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist