Jonathan Ashman, DMD

Individual provider Active NPI General Practice Dentistry · Provo, UT

NPI 1851968283 · NPPES record last updated Jun 4, 2021

Key facts

NPI
1851968283
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
12317355-9923 (UT)
Practice address
3610 N University Ave
Provo, UT 84604-4437
Phone
(801) 377-9600
NPI assigned
Jun 4, 2021
Sex
Male
Sole proprietor
No

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
12317355-9923UTMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 12317355-9923 UT Yes

Addresses

Primary practice location

3610 N University Ave
Provo, UT 84604-4437

Mailing address

3610 N University Ave
Provo, UT 84604-4437
Phone (801) 377-9600

Other providers in Provo, UT

All providers in Provo, UT · General Practice Dentistry in Utah

Sources for this page

Verify at the official NPI Registry.