Provider Demographics
NPI:1821724394
Name:JOKI, ASHLEY C (ADT)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:C
Last Name:JOKI
Suffix:
Gender:F
Credentials:ADT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 W 42ND ST
Mailing Address - Street 2:
Mailing Address - City:HIBBING
Mailing Address - State:MN
Mailing Address - Zip Code:55746-1747
Mailing Address - Country:US
Mailing Address - Phone:218-263-8381
Mailing Address - Fax:218-263-8383
Practice Address - Street 1:802 W 42ND ST
Practice Address - Street 2:
Practice Address - City:HIBBING
Practice Address - State:MN
Practice Address - Zip Code:55746-1747
Practice Address - Country:US
Practice Address - Phone:218-263-8381
Practice Address - Fax:218-263-8383
Is Sole Proprietor?:No
Enumeration Date:2022-07-27
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNDT062125J00000X, 125K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes125K00000XDental ProvidersAdvanced Practice Dental Therapist
No125J00000XDental ProvidersDental Therapist