Individual provider Active NPI

John Ottis Ashby Jr., DDS MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Virginia Beach, VA
National Provider Identifier
1508952946
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
0401411276 Issued in VA
Practice address
4345 4 Bonney Road
Suite 101
Virginia Beach, VA 23452-1200
Phone
(757) 340-7000
Fax
(757) 498-6498
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X 0401411276 VA Primary

Addresses

Primary practice location

4345 4 Bonney Road
Suite 101
Virginia Beach, VA 23452-1200

Mailing address

4345 4 Bonney Road
Suite 101
Virginia Beach, VA 23452-1200
Phone (757) 340-7000

Other identifiers 2

IdentifierTypeStateIssuer
9181657MedicaidVA
1695363OtherVAUNITED CONCORDIA

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
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
0401411276VAMDOrthodontics and Dentofacial Orthopedic Dentist

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1508952946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4345 4 BONNEY ROAD",
            "address_2": "SUITE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234521200",
            "telephone_number": "757-340-7000",
            "fax_number": "757-498-6498"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4345 4 BONNEY ROAD",
            "address_2": "SUITE 101",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234521200",
            "telephone_number": "757-340-7000",
            "fax_number": "757-498-6498"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ASHBY",
        "first_name": "JOHN",
        "middle_name": "OTTIS",
        "name_suffix": "Jr.",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "VA",
            "license": "0401411276",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9181657",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1695363",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.