Provider Demographics
NPI:1891831947
Name:ASTON, JOHN DOUGLAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:DOUGLAS
Last Name:ASTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 W 26TH ST
Mailing Address - Street 2:APT 19A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-1001
Mailing Address - Country:US
Mailing Address - Phone:718-772-6557
Mailing Address - Fax:718-835-3096
Practice Address - Street 1:1299 CORPORATE DR
Practice Address - Street 2:APT 813
Practice Address - City:WESTBURY
Practice Address - State:NY
Practice Address - Zip Code:11590-6621
Practice Address - Country:US
Practice Address - Phone:718-772-6557
Practice Address - Fax:718-835-3096
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY049962-1122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02310263Medicaid