Ashley Dawn Soucy, LD

Primary specialty

DenturistTaxonomy code 122400000X

License

DTR5539 Issued in ME

Practice address

980 Forest Ave Ste 104
Portland, ME 04103-3357

Phone

(207) 774-7645

NPI assigned

Aug 3, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Ashley Dawn Libby Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Ads Denture Technologies LLC

  • Denturist
  • Portland, ME
  • NPI 1467225466
  NPD Authorized official
• Jetport Denture Center Inc.

  • Denturist
  • Portland, ME
  • NPI 1922723543
  NPD

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1801560842",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "57 NOWELL ST",
            "city": "NORTH BERWICK",
            "state": "ME",
            "postal_code": "039066519",
            "telephone_number": "207-794-5322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 FOREST AVE STE 104",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041033357",
            "telephone_number": "207-774-7645"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOUCY",
        "first_name": "ASHLEY",
        "middle_name": "DAWN",
        "credential": "LD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-08-03",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122400000X",
            "taxonomy_group": "",
            "desc": "Denturist",
            "state": "ME",
            "license": "DTR5539",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MAINE DENTAL BOARD",
            "identifier": "DTR5539",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "LIBBY",
            "middle_name": "DAWN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gary Samuel Sorcher, PA-C
• Hannah Sorensen
• Margaret Tekla Soroka, M.D.
• Cynthia Sortwell, M.D.
• Lora Soucy Moreau, OTR/L
• Jacob W Soucy, PA-S
• Jennifer Anne Soucy, PHARMD
• Soul Sanctuary, LLC
• Helen M Soule, MD
• Soundings Therapy Group, PLLC

• Denturist in Portland, ME
• Providers in Portland, ME by specialty
• Denturist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; 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.