Provider Demographics
NPI:1164427795
Name:PATNOE, ASHLEY JANE (DDS)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:JANE
Last Name:PATNOE
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 1:1573 WASHINGTON ST E
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25311-2505
Mailing Address - Country:US
Mailing Address - Phone:304-344-0788
Mailing Address - Fax:304-344-2599
Practice Address - Street 1:1573 WASHINGTON ST E
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25311-2505
Practice Address - Country:US
Practice Address - Phone:304-344-0788
Practice Address - Fax:304-344-2599
Is Sole Proprietor?:No
Enumeration Date:2005-06-20
Last Update Date:2022-05-06
Deactivation Date:2006-03-20
Deactivation Code:
Reactivation Date:2006-03-28
Provider Licenses
StateLicense IDTaxonomies
WV35941223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV4003075000Medicaid