Provider Demographics
NPI:1295182244
Name:ASHBURN, LAUREN ASHLEY (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:ASHLEY
Last Name:ASHBURN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:LAUREN
Other - Middle Name:ASHLEY
Other - Last Name:FURILLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:132 PIONEER TRL
Mailing Address - Street 2:
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-1167
Mailing Address - Country:US
Mailing Address - Phone:952-361-3740
Mailing Address - Fax:
Practice Address - Street 1:132 PIONEER TRL
Practice Address - Street 2:
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-1167
Practice Address - Country:US
Practice Address - Phone:952-361-3740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-05-19
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND13689122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist