Provider Demographics
NPI:1609248277
Name:BERRY, ASHLEY BARBARA (RDH)
Entity Type:Individual
Prefix:MS
First Name:ASHLEY
Middle Name:BARBARA
Last Name:BERRY
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14305 E MISSISSIPPI AVE APT 151
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-4668
Mailing Address - Country:US
Mailing Address - Phone:303-475-7221
Mailing Address - Fax:
Practice Address - Street 1:14305 E MISSISSIPPI AVE APT 151
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-4668
Practice Address - Country:US
Practice Address - Phone:303-475-7221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-22
Last Update Date:2015-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODH.002024166124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist