Healthcare Provider Details

I. General information

NPI: 1528813532
Provider Name (Legal Business Name): ASHWINI B PILLA DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/22/2024
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

410 W LANCASTER AVE STE 106
DEVON PA
19333-1588
US

IV. Provider business mailing address

410 W LANCASTER AVE STE 106
DEVON PA
19333-1588
US

V. Phone/Fax

Practice location:
  • Phone: 610-646-7106
  • Fax:
Mailing address:
  • Phone: 610-646-7106
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDSO45499
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: