Provider Demographics
NPI:1568470466
Name:ASAY, ERIC STAHLE (DDS)
Entity Type:Individual
Prefix:MR
First Name:ERIC
Middle Name:STAHLE
Last Name:ASAY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11028 W ALDBURY AVE
Mailing Address - Street 2:
Mailing Address - City:NAMPA
Mailing Address - State:ID
Mailing Address - Zip Code:83651-5072
Mailing Address - Country:US
Mailing Address - Phone:208-466-3360
Mailing Address - Fax:208-468-9592
Practice Address - Street 1:11028 W ALDBURY AVE
Practice Address - Street 2:
Practice Address - City:NAMPA
Practice Address - State:ID
Practice Address - Zip Code:83651-5072
Practice Address - Country:US
Practice Address - Phone:208-466-3360
Practice Address - Fax:208-468-9592
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-04
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD20631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID0000100OtherBLUE SHIELD
ID60426OtherBLUE CROSS
ID002375600Medicaid