Provider Demographics
NPI:1073124350
Name:STEVENSON, ASHLEY N (DDS)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:N
Last Name:STEVENSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2630 BISSONNET ST APT 2113
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77005-1385
Mailing Address - Country:US
Mailing Address - Phone:573-248-6802
Mailing Address - Fax:
Practice Address - Street 1:6360 GARTH RD STE 105
Practice Address - Street 2:
Practice Address - City:BAYTOWN
Practice Address - State:TX
Practice Address - Zip Code:77521-5104
Practice Address - Country:US
Practice Address - Phone:281-769-4171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX36492122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist