Provider Demographics
NPI:1568629236
Name:ADASHEK, SCOTT DANIEL (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:DANIEL
Last Name:ADASHEK
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11875 N 110TH WAY
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85259-3075
Mailing Address - Country:US
Mailing Address - Phone:414-587-6793
Mailing Address - Fax:
Practice Address - Street 1:2080 E WILLIAMS FIELD RD STE 104
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85295
Practice Address - Country:US
Practice Address - Phone:480-284-6402
Practice Address - Fax:480-621-7022
Is Sole Proprietor?:No
Enumeration Date:2008-05-20
Last Update Date:2019-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD079511223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN190000990Medicare PIN