Provider Demographics
NPI:1053922534
Name:GLISSMAN, CHELSEA (DDS)
Entity type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:
Last Name:GLISSMAN
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 1:8700 TUDSBURY RD
Mailing Address - Street 2:
Mailing Address - City:LOOMIS
Mailing Address - State:CA
Mailing Address - Zip Code:95650-9717
Mailing Address - Country:US
Mailing Address - Phone:916-749-8884
Mailing Address - Fax:
Practice Address - Street 1:5800 STANFORD RANCH RD STE 110
Practice Address - Street 2:
Practice Address - City:ROCKLIN
Practice Address - State:CA
Practice Address - Zip Code:95765-4389
Practice Address - Country:US
Practice Address - Phone:916-435-4222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-10
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1051591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice