Healthcare Provider Details

I. General information

NPI: 1619037223
Provider Name (Legal Business Name): DR ASH INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/12/2006
Last Update Date: 09/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4777 HIGBEE AVE NW
CANTON OH
44718-2551
US

IV. Provider business mailing address

4425 FULTON DR NW
CANTON OH
44718-2863
US

V. Phone/Fax

Practice location:
  • Phone: 330-493-0010
  • Fax: 330-493-8440
Mailing address:
  • Phone: 330-493-0010
  • Fax: 330-493-8440

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number19406
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number19446
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. JONATHAN M. ASH
Title or Position: PRESIDENT
Credential: DDS
Phone: 330-493-0010