Provider Demographics
NPI:1255013967
Name:AUSI, MONICA (DMD)
Entity type:Individual
Prefix:DR
First Name:MONICA
Middle Name:
Last Name:AUSI
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:479 W DOUGLAS AVE
Mailing Address - Street 2:
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85233-3262
Mailing Address - Country:US
Mailing Address - Phone:480-217-5103
Mailing Address - Fax:
Practice Address - Street 1:479 W DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85233-3262
Practice Address - Country:US
Practice Address - Phone:480-217-5103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-02
Last Update Date:2023-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0118431223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice