Provider Demographics
NPI:1114597614
Name:SCHERBENSKE, ASHLEY CLAIRE
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:CLAIRE
Last Name:SCHERBENSKE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1859 28TH ST APT 505
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80216-5276
Mailing Address - Country:US
Mailing Address - Phone:703-939-4052
Mailing Address - Fax:
Practice Address - Street 1:4624 CENTRAL PARK BLVD UNIT 102
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80238-3436
Practice Address - Country:US
Practice Address - Phone:303-945-2699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2023-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CO002055571223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program