Amanda Gaynor Ashley, DMD, MSEDU, MS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

910 Issued in KY

Practice address

234 Natchez Trace Ave
Bowling Green, KY 42103-7995

Phone

(270) 715-5437

NPI assigned

Mar 19, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 5

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pediatric Dentistry of Southern Kentucky

  • Pediatric Dentistry
  • Bowling Green, KY
  • NPI 1083067482
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1124142773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234 NATCHEZ TRACE AVE",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421037995",
            "telephone_number": "270-715-5437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 NATCHEZ TRACE AVE",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421037995",
            "telephone_number": "270-715-5437"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "280 Burley Ave",
            "address_purpose": "LOCATION",
            "city": "Hopkinsville",
            "state": "KY",
            "postal_code": "422408725",
            "country_code": "US",
            "telephone_number": "270-874-4971",
            "fax_number": "270-874-1063",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ASHLEY",
        "first_name": "AMANDA",
        "middle_name": "GAYNOR",
        "name_prefix": "Dr.",
        "credential": "DMD, MSEDU, MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-19",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-023178",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "AK",
            "license": "1010",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TN",
            "license": "9425",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KY",
            "license": "9156",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KY",
            "license": "910",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100232870",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayla Ashby, MA, LPCC
• Hayley Ashcraft, RBT
• Eleanor Asher, MD
• Ashley Circle Inpatient Services LLC
• Ashley Vicari Counseling, LLC
• Jessica Keirsten Ashwill
• Aspire Mentoring Foundation LLC
• Associated Foot and Ankle Clinics PSC
• Associates in Counseling and Psychology, LLC
• Associates in Pediatric Therapy LLC

• Pediatric Dentistry in Bowling Green, KY
• Providers in Bowling Green, KY by specialty
• Pediatric Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.