Provider Demographics
NPI:1427216829
Name:HODERS, ASHLEY BROOKE (DMD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:BROOKE
Last Name:HODERS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8226 S 15TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98465-2243
Mailing Address - Country:US
Mailing Address - Phone:954-254-8307
Mailing Address - Fax:
Practice Address - Street 1:720 OLIVE WAY STE 810
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1836
Practice Address - Country:US
Practice Address - Phone:206-628-0404
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-02
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN179491223G0001X
WADE605453491223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
No1223G0001XDental ProvidersDentistGeneral Practice