Provider Demographics
NPI:1639487903
Name:SEIDE, ASHLEY N (DMD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:N
Last Name:SEIDE
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 1:9865 W ROOSEVELT RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-2767
Mailing Address - Country:US
Mailing Address - Phone:708-344-4334
Mailing Address - Fax:708-344-4347
Practice Address - Street 1:9865 W ROOSEVELT RD
Practice Address - Street 2:SUITE 101
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-2767
Practice Address - Country:US
Practice Address - Phone:708-344-4334
Practice Address - Fax:708-344-4347
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-20
Last Update Date:2016-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL0190284061223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice