Healthcare Provider Details

I. General information

NPI: 1073124350
Provider Name (Legal Business Name): ASHLEY N STEVENSON DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2020
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8340 MISSION RD STE 118
PRAIRIE VILLAGE KS
66206-1362
US

IV. Provider business mailing address

4121 W 83RD ST STE 239
PRAIRIE VILLAGE KS
66208-5323
US

V. Phone/Fax

Practice location:
  • Phone: 573-248-6802
  • Fax:
Mailing address:
  • Phone: 573-248-6802
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number62035
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: