=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407767304
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DWK DENTAL LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/17/2026
-----------------------------------------------------
Last Update Date | 09/17/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 145 NUTT RD
-----------------------------------------------------
City | PHOENIXVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19460-3905
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-933-3881
-----------------------------------------------------
Fax | 610-933-9383
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 145 NUTT RD
-----------------------------------------------------
City | PHOENIXVILLE
-----------------------------------------------------
State | PA
-----------------------------------------------------
Zip | 19460-3905
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 610-933-3881
-----------------------------------------------------
Fax | 610-933-9383
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MRS. ASHLEY NICOLE HOFFMAN
-----------------------------------------------------
Credential | RDH, PHDHP, EFDA
-----------------------------------------------------
Telephone | 610-955-9858
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QD0000X
-----------------------------------------------------
Taxonomy Name | Dental Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------