Provider Demographics
NPI:1952486235
Name:AINSWORTH, DAVID S (DMD)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:S
Last Name:AINSWORTH
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 1:775 US HIGHWAY 1
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-4679
Mailing Address - Country:US
Mailing Address - Phone:732-287-6611
Mailing Address - Fax:732-287-6419
Practice Address - Street 1:775 US HIGHWAY 1
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08817-4679
Practice Address - Country:US
Practice Address - Phone:732-287-6611
Practice Address - Fax:732-287-6419
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI13729122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist