1821656976 NPI number — ASHLEY S DESAIX DDS PA

Table of content: (NPI 1629150602)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821656976 NPI number — ASHLEY S DESAIX DDS PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASHLEY S DESAIX DDS PA
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:
RESPAIR SLEEP
Provider Other Organization Name Type Code:
3
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:
1821656976
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/13/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3200 BLUE RIDGE RD STE 224
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RALEIGH
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27612-8087
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-413-3128
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3200 BLUE RIDGE RD STE 224
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RALEIGH
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27612-8087
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-307-8960
Provider Business Practice Location Address Fax Number:
919-893-1934
Provider Enumeration Date:
06/04/2019

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
DESAIX
Authorized Official First Name:
TODD
Authorized Official Middle Name:
Authorized Official Title or Position:
CFO & TREASURER
Authorized Official Telephone Number:
919-307-8960

Provider Taxonomy Codes

  • Taxonomy code: 122300000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 332BC3200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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