1598063513 NPI number — PAUL W. ASHLEY, DDS., PC.

Table of content: (NPI 1598063513)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598063513 NPI number — PAUL W. ASHLEY, DDS., PC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PAUL W. ASHLEY, DDS., PC.
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:
1598063513
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/20/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7411 RIGGS ROAD
Provider Second Line Business Mailing Address:
#101
Provider Business Mailing Address City Name:
HYATTSVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20783
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-439-5680
Provider Business Mailing Address Fax Number:
301-439-1140

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7411 RIGGS ROAD
Provider Second Line Business Practice Location Address:
#101
Provider Business Practice Location Address City Name:
HYATTSVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20783
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-439-5680
Provider Business Practice Location Address Fax Number:
301-439-1140
Provider Enumeration Date:
03/01/2011

Additional Information

Authorized Official

Authorized Official Last Name:
ASHLEY
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
W.
Authorized Official Title or Position:
PRESIDENT.
Authorized Official Telephone Number:
301-439-5680

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  10184 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 039591900 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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