Provider Demographics
NPI:1174264279
Name:ASHA W. ARTIS DDS, PLLC
Entity Type:Organization
Organization Name:ASHA W. ARTIS DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHA
Authorized Official - Middle Name:W
Authorized Official - Last Name:ARTIS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:757-826-7372
Mailing Address - Street 1:2613 W MERCURY BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-3105
Mailing Address - Country:US
Mailing Address - Phone:757-826-7372
Mailing Address - Fax:757-826-1739
Practice Address - Street 1:2613 W MERCURY BLVD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-3105
Practice Address - Country:US
Practice Address - Phone:757-826-7372
Practice Address - Fax:757-826-1739
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-05
Last Update Date:2022-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental