Provider Demographics
NPI:1902153869
Name:DOHMAN, ASHLIE BROOKE (DDS)
Entity Type:Individual
Prefix:
First Name:ASHLIE
Middle Name:BROOKE
Last Name:DOHMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5000 RIVERDALE RD APT 301
Mailing Address - Street 2:
Mailing Address - City:RIVERDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07457-1726
Mailing Address - Country:US
Mailing Address - Phone:443-532-5955
Mailing Address - Fax:
Practice Address - Street 1:199 STATE RT 284
Practice Address - Street 2:
Practice Address - City:WANTAGE
Practice Address - State:NJ
Practice Address - Zip Code:07461-3417
Practice Address - Country:US
Practice Address - Phone:973-875-7127
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-10
Last Update Date:2014-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI02539400122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist