MEDICARE: DAVID ASHLEY MD DMD ORAL SURGERY GROUP, A PROFESSIONAL DENTAL CORPORATION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223S0112X	Oral and Maxillofacial Surgery (Dentist)

General Provider Information

NPI Number	:	1538040860
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DAVID ASHLEY MD DMD ORAL SURGERY GROUP, A PROFESSIONAL DENTAL CORPORATION

Provider Business Mailing Address
First Line	:	813 SHADES CREEK PKWY STE 205
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35209-4512
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1512 CAMELLIA BLVD
Second Line	:
City	:	LAFAYETTE
State	:	LA
Zip	:	70508-6379
Country	:	US
Telephone Number	:	337-541-2260
Fax Number	:

Authorized Official
Title or Position	:	MEMBER
Name	:	DAVID HOUSTON ASHLEY
Credential	:	MD, DMD
Telephone Number	:	501-208-1593

Provider Enumeration Date	:	09/11/2025
Last Update Date	:	01/28/2026

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