William Scott Ash, DDS
Individual provider Active NPI Dentist · Lucedale, MS
NPI 1710080346 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1710080346
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 186380 (MS)
- Practice address
- 11255 Old Hwy 63 South
Lucedale, MS 39452 - Phone
- (601) 947-3318
- Fax
- (601) 947-3320
- NPI assigned
- Sep 7, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: No · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160504002770 | MS | Order and Referring Only - Dentist |
8426357906 |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 186380 | MS | MD | Dentist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 186380 | MS | Yes |
Addresses
Primary practice location
11255 Old Hwy 63 South
Lucedale, MS 39452
Mailing address
PO Box 1005
Lucedale, MS 39452-1005
Phone (601) 947-3318
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00064740 | Medicaid | MS |
Other providers in Lucedale, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.