Individual provider Active NPI

Ashley Walsh, DDS

  • General Practice Dentistry
  • Shawano, WI
National Provider Identifier
1811377054
Registry record updated Jul 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1001653-15 Issued in WI
Practice address
657 N Main St
Shawano, WI 54166-1216
Phone
(715) 524-2581
NPI assigned
Jun 3, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 1001653-15 WI Primary

Addresses

Primary practice location

657 N Main St
Shawano, WI 54166-1216

Mailing address

657 N Main St
Shawano, WI 54166-1216
Phone (715) 524-2581

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
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
I20170926002763 WI Order and Referring Only - DentistPractitioner - Dentist 0143594358

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1001653-15WIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Ashley Walsh and Associates, LLC CurrentSince Aug 1, 2021 Accepting new patients
Walsh Dental Appleton, LLC CurrentSince Apr 21, 2024 Accepting new patients

Locations

657 N Main St
Shawano, WI 54166
Phone (715) 524-2581

920 E 5th St
Shawano, WI 54166
Phone (715) 524-2001

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1433289600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627084800000",
    "number": "1811377054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "657 N MAIN ST",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541661216",
            "telephone_number": "715-524-2581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "657 N MAIN ST",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541661216",
            "telephone_number": "715-524-2581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALSH",
        "first_name": "ASHLEY",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-03",
        "last_updated": "2021-07-24",
        "certification_date": "2021-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1001653-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shawano, WI

Sources for this page

Verify at the official NPI Registry.