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General NPI Number Information
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NPI Number | 1134794654
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Entity Type | Individual
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Provider Name | ASHLYNN NICOLE LOENSER
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Gender | Female
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Dates
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Enumeration Date | 05/26/2021
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Last Update Date | 11/24/2025
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Provider Practice Location Address
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Address Line | 10941 RAVEN RIDGE RD STE 115
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City | RALEIGH
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State | NC
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Zip | 27614-6487
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Country | US
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Telephone | 919-870-1201
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Fax |
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Provider Business Mailing Address
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Address Line | 3924 TYLER BLUFF LN
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City | RALEIGH
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State | NC
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Zip | 27616-8330
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Country | US
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Telephone | 269-357-4902
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 13981
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License Number State | NC
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