Provider Demographics
NPI:1053630228
Name:ASHCROFT, JASON (DMD, MSD)
Entity Type:Individual
Prefix:
First Name:JASON
Middle Name:
Last Name:ASHCROFT
Suffix:
Gender:M
Credentials:DMD, MSD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 FM 156 S
Mailing Address - Street 2:SUITE 100
Mailing Address - City:HASLET
Mailing Address - State:TX
Mailing Address - Zip Code:76052-3605
Mailing Address - Country:US
Mailing Address - Phone:817-439-4999
Mailing Address - Fax:
Practice Address - Street 1:544 FM 156 S
Practice Address - Street 2:SUITE 100
Practice Address - City:HASLET
Practice Address - State:TX
Practice Address - Zip Code:76052-3605
Practice Address - Country:US
Practice Address - Phone:817-439-4999
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-26
Last Update Date:2015-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN42000396A1223G0001X
PADS0381161223G0001X
TX276941223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No1223G0001XDental ProvidersDentistGeneral Practice