Individual provider Active NPI

Ashley Marie De la Vega, DDS

  • Dentist
  • Jacksonville, FL
National Provider Identifier
1336879576
Registry record updated May 12, 2025
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Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DL15493 Issued in MA
Practice address
6327 Argyle Forest Blvd
Jacksonville, FL 32244-6667
Phone
(904) 772-8898
NPI assigned
Jun 11, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DL15493 MA Primary

Addresses

Primary practice location

6327 Argyle Forest Blvd
Jacksonville, FL 32244-6667

Mailing address

26 Queen St
Worcester, MA 01610-2473
Phone (508) 860-7910

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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

Enrollment IDStateProvider typePAC IDDetails
I20221214003177 MA Order and Referring Only - DentistPractitioner - Dentist 2961871884

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1654905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747008000000",
    "number": "1336879576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 QUEEN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016102473",
            "telephone_number": "508-860-7910",
            "fax_number": "508-860-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6327 ARGYLE FOREST BLVD",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322446667",
            "telephone_number": "904-772-8898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LA VEGA",
        "first_name": "ASHLEY",
        "middle_name": "MARIE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-11",
        "last_updated": "2025-05-12",
        "certification_date": "2025-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MA",
            "license": "DL15493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, FL

Sources for this page

Verify at the official NPI Registry.