Provider Demographics
NPI:1659304376
Name:ASHLEY, WYLENE (DENTAL HYGIENIST)
Entity type:Individual
Prefix:
First Name:WYLENE
Middle Name:
Last Name:ASHLEY
Suffix:
Gender:F
Credentials:DENTAL HYGIENIST
Other - Prefix:
Other - First Name:WYLENE
Other - Middle Name:
Other - Last Name:ASHLEY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DENTAL HYGIENIST
Mailing Address - Street 1:10200 SW 140TH ST
Mailing Address - Street 2:10200 SW 140TH STREET
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-6663
Mailing Address - Country:US
Mailing Address - Phone:305-232-9446
Mailing Address - Fax:305-575-3373
Practice Address - Street 1:1201 NW 16H ST.
Practice Address - Street 2:1201 NW 16 ST.
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33125
Practice Address - Country:US
Practice Address - Phone:305-575-3146
Practice Address - Fax:305-575-3373
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDH06967124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist