Provider Demographics
NPI:1023421740
Name:ASHTON, NIELSON KIRK (DMD)
Entity type:Individual
Prefix:
First Name:NIELSON
Middle Name:KIRK
Last Name:ASHTON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2180 E 4500 S STE 250
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84117-4475
Mailing Address - Country:US
Mailing Address - Phone:801-272-8609
Mailing Address - Fax:
Practice Address - Street 1:2180 E 4500 S STE 250
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84117-4475
Practice Address - Country:US
Practice Address - Phone:801-272-8609
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-10
Last Update Date:2020-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9296076122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist