Provider Demographics
NPI:1851709059
Name:ASHOTY, REEMON
Entity Type:Individual
Prefix:
First Name:REEMON
Middle Name:
Last Name:ASHOTY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6311 HILLCREST RD STE 200
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-8799
Mailing Address - Country:US
Mailing Address - Phone:972-335-4145
Mailing Address - Fax:
Practice Address - Street 1:6311 HILLCREST RD STE 200
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75035-8799
Practice Address - Country:US
Practice Address - Phone:972-335-4145
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-31
Last Update Date:2023-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX30253122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist