Individual provider Active NPI

Ashley Nicole Younkman-Reynolds, D.M.D

  • Dentist
  • Port Charlotte, FL
National Provider Identifier
1376806828
Registry record updated Jun 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN19749 Issued in FL
Practice address
19240 Quesada Ave
Port Charlotte, FL 33948-3126
Phone
(941) 743-7435
Fax
(941) 743-7429
NPI assigned
Jun 20, 2012
Last updated
Jun 23, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN19749 FL Primary

Addresses

Primary practice location

19240 Quesada Ave
Port Charlotte, FL 33948-3126

Mailing address

19240 Quesada Ave
Port Charlotte, FL 33948-3126
Phone (941) 743-7435

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DN19749FLMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Panther Hollow Family Dental PA CurrentSince Jun 22, 2021 Accepting new patients
Panther Hollow Dental Lodge, PL Past Accepting new patients

Locations

19240 Quesada Ave
Port Charlotte, FL 33948
Phone (941) 743-7435

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1340150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340409600000",
    "number": "1376806828",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19240 QUESADA AVE",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339483126",
            "telephone_number": "941-743-7435",
            "fax_number": "941-743-7429"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19240 QUESADA AVE",
            "city": "PORT CHARLOTTE",
            "state": "FL",
            "postal_code": "339483126",
            "telephone_number": "941-743-7435",
            "fax_number": "941-743-7429"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YOUNKMAN-REYNOLDS",
        "first_name": "ASHLEY",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-20",
        "last_updated": "2012-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "FL",
            "license": "DN19749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Charlotte, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.