Provider Demographics
NPI:1457081721
Name:O'BRIEN, ASHLEIGH NICHOLE (DDS)
Entity Type:Individual
Prefix:
First Name:ASHLEIGH
Middle Name:NICHOLE
Last Name:O'BRIEN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ASHLEIGH
Other - Middle Name:NICHOLE
Other - Last Name:DURDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1320 S LAPEER RD
Mailing Address - Street 2:
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48360-1435
Mailing Address - Country:US
Mailing Address - Phone:248-693-6213
Mailing Address - Fax:
Practice Address - Street 1:1320 S LAPEER RD
Practice Address - Street 2:
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48360-1435
Practice Address - Country:US
Practice Address - Phone:248-693-6213
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-10
Last Update Date:2022-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901601405122300000X
MI2901601405APP22122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist