1043332745 NPI number — ASH & ROBERTS DDS PLLC

Table of content: (NPI 1043332745)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043332745 NPI number — ASH & ROBERTS DDS PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASH & ROBERTS DDS PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043332745
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1660
Provider Second Line Business Mailing Address:
2409 BORST AVE
Provider Business Mailing Address City Name:
CENTRALIA
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98531
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-736-8380
Provider Business Mailing Address Fax Number:
360-736-2192

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2409 BORST AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CENTRALIA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98531
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-736-8380
Provider Business Practice Location Address Fax Number:
360-736-2192
Provider Enumeration Date:
04/04/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ASH
Authorized Official First Name:
STEVEN
Authorized Official Middle Name:
LOWELL
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
360-736-8380

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  5151 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1223G0001X , with the licence number: 8192 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 606932 . This is a "UNITED CONCORDIA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5038930 . This is a "DSHS" identifier . This identifiers is of the category "OTHER".




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