Provider Demographics
NPI:1033264445
Name:ASHOFF, RANDY J (DMD)
Entity Type:Individual
Prefix:DR
First Name:RANDY
Middle Name:J
Last Name:ASHOFF
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2437 W 26TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16506-3220
Mailing Address - Country:US
Mailing Address - Phone:814-833-6662
Mailing Address - Fax:814-314-0280
Practice Address - Street 1:2437 W 26TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16506-3220
Practice Address - Country:US
Practice Address - Phone:814-833-6662
Practice Address - Fax:814-314-0280
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-24
Last Update Date:2007-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS025531L1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics