Healthcare Provider Details

I. General information

NPI: 1780211417
Provider Name (Legal Business Name): ASHLEY CHIMELIS DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/24/2020
Last Update Date: 11/20/2025
Certification Date: 11/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 CALLE MUNOZ RIVERA W
RINCON PR
00677-2127
US

IV. Provider business mailing address

PO BOX 638
RINCON PR
00677-0638
US

V. Phone/Fax

Practice location:
  • Phone: 787-823-5500
  • Fax:
Mailing address:
  • Phone: 787-823-5500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2022019200
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: