Provider Demographics
NPI:1003255878
Name:MENCARELLI, ASHLEY RAE (DMD, MS)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:RAE
Last Name:MENCARELLI
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1163 FEHL LN
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45230-4349
Mailing Address - Country:US
Mailing Address - Phone:513-231-0041
Mailing Address - Fax:
Practice Address - Street 1:1163 FEHL LN
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45230-4349
Practice Address - Country:US
Practice Address - Phone:513-231-0041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-14
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY93421223X0400X
OH30.0255051223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY9342OtherDENTAL LICENSE NUMBER