Basic Information
| Provider Information | |||||||||
| NPI: | 1922471572 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LINDSEY | ||||||||
| FirstName: | ASHLEY | ||||||||
| MiddleName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 1800 COMMUNITY | ||||||||
| Address2: | |||||||||
| City: | CLINTON | ||||||||
| State: | MO | ||||||||
| PostalCode: | 647358804 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8448538937 | ||||||||
| FaxNumber: | 6369315304 | ||||||||
| Practice Location | |||||||||
| Address1: | 4300 GRAVOIS RD | ||||||||
| Address2: | |||||||||
| City: | HOUSE SPRINGS | ||||||||
| State: | MO | ||||||||
| PostalCode: | 630512304 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6363210150 | ||||||||
| FaxNumber: | 6363755157 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/04/2015 | ||||||||
| LastUpdateDate: | 10/25/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/25/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 124Q00000X | 2015017421 | MO | Y | Dental Providers | Dental Hygienist |
No ID Information.