Provider Demographics
NPI:1649924879
Name:ATHANS, ASHA S (DDS)
Entity type:Individual
Prefix:DR
First Name:ASHA
Middle Name:S
Last Name:ATHANS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:485 JOYCE LN W
Mailing Address - Street 2:
Mailing Address - City:ARNOLD
Mailing Address - State:MD
Mailing Address - Zip Code:21012-2240
Mailing Address - Country:US
Mailing Address - Phone:443-346-3411
Mailing Address - Fax:
Practice Address - Street 1:485 JOYCE LN W
Practice Address - Street 2:
Practice Address - City:ARNOLD
Practice Address - State:MD
Practice Address - Zip Code:21012-2240
Practice Address - Country:US
Practice Address - Phone:443-346-3411
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-07
Last Update Date:2022-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD173181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty