Ashley Lynn Wildhaber, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DE61085858 Issued in WA

Practice address

111 Tumwater Blvd SE # 301
Tumwater, WA 98501-6400

Phone

(360) 786-9354

NPI assigned

Oct 26, 2020

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 Lynn Basher Former name

Medicare fee-for-service enrollment

Enrolled in WA

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

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Ashley Dental LLC

  • Dentist
  • Tenino, WA
  • NPI 1588457105
  NPD Authorized official

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

{
    "created_epoch": "1603670400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603670400000",
    "number": "1851991319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 TUMWATER BLVD SE # 301",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985016400",
            "telephone_number": "360-786-9354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 TUMWATER BLVD SE # 301",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985016400",
            "telephone_number": "360-786-9354"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILDHABER",
        "first_name": "ASHLEY",
        "middle_name": "LYNN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-26",
        "last_updated": "2020-10-26",
        "certification_date": "2020-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE61085858",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1220931301",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ASHLEY",
            "last_name": "BASHER",
            "middle_name": "LYNN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Monique T Wiedrich, LMP
• Samantha C Wikan, LMT
• Diana Wilcox, PMHNP
• Ronald Dale Wilcox, DC
• Karolina Agnieszka Wilczynska-Oberc
• Monica Anne Wilhelm, MD
• Willamette Dental Group, P.C.
• Stephen M Williams
• Steve E Williams, LMT
• Steven Patrick Williams, LMFT

• Dentist in Tumwater, WA
• Providers in Tumwater, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.