Ashley Marie Nowdomski, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

2018019657 Issued in MO

Practice address

1353 E Mound Rd Ste 101
Decatur, IL 62526-3600

Phone

(178) 757-6002

NPI assigned

Jun 19, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Virden Family Dental

  • Dental Clinic/Center
  • Virden, IL
  • NPI 1649955923
  NPD Authorized official
• Hebert DMD, Brown DMD & Associates, LLC, Dba Lifesmile Dental Care

  • Dental Clinic/Center
  • Hazelwood, MO
  • NPI 1447419684
  NPD (past)

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565740800000",
    "number": "1972097459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5700 HIGHLANDS PLAZA DR APT 5036",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631101378",
            "telephone_number": "708-897-7259"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1353 E MOUND RD STE 101",
            "city": "DECATUR",
            "state": "IL",
            "postal_code": "625263600",
            "telephone_number": "178-757-6002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOWDOMSKI",
        "first_name": "ASHLEY",
        "middle_name": "MARIE",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-19",
        "last_updated": "2019-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2018019657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Uniquinca K R Nixon Jackson
• Northland Hearing Centers, Inc
• Northland Hearing Centers, Inc
• Patricia Elaine Norton, DMD
• Roger K Norton, M.D.
• Emily Ann Ntor-Ue, FNP
• Jacob Nuss
• Worlali Moses Nutakor, M.D.
• Monica L Nyman, MS RD LD IN
• Latisha Ann O Neal, LCSW

• Dentist in Decatur, IL
• Providers in Decatur, IL by specialty
• Dentist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2019; 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.