Provider Demographics
NPI:1043663347
Name:MASSEY, ASHLEY HEINECKE (DMD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:HEINECKE
Last Name:MASSEY
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3709 BEAUMONT LOOP
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-0601
Mailing Address - Country:US
Mailing Address - Phone:352-584-5303
Mailing Address - Fax:
Practice Address - Street 1:7135 MARINER BLVD
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-1048
Practice Address - Country:US
Practice Address - Phone:352-584-5303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-21
Last Update Date:2016-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN22000122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist