Provider Demographics
NPI:1427211556
Name:GRIFFON, ASHLEY LANDRY (DDS)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:LANDRY
Last Name:GRIFFON
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 1:1669 LOBDELL AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-8297
Mailing Address - Country:US
Mailing Address - Phone:225-200-5100
Mailing Address - Fax:
Practice Address - Street 1:1669 LOBDELL AVE
Practice Address - Street 2:SUITE B
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70806-8297
Practice Address - Country:US
Practice Address - Phone:225-925-2273
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA59041223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1859044Medicaid