Donald G. Ashburn Jr., D.D.S.
Individual provider Active NPI Dentist · Edmond, OK
NPI 1962540336 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1962540336
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Dentist 122300000X
- License
- 4954 (OK)
- Practice address
- 340 S Santa Fe Ave
Edmond, OK 73003-6328 - Phone
- (405) 348-7775
- NPI assigned
- Feb 1, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4954 | OK | MD | Emergency Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kairos Pronoia, PLLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 4954 | OK | Yes |
Addresses
Primary practice location
340 S Santa Fe Ave
Edmond, OK 73003-6328
Mailing address
3903 Creek Bank Dr
Edmond, OK 73003-3547
Other providers in Edmond, OK
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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.