Provider Demographics
NPI:1528846235
Name:DORADO, ASHLEY (BSDH, RDH, PHDH)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:DORADO
Suffix:
Gender:F
Credentials:BSDH, RDH, PHDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1026 JAY ST STE B205
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28208-4431
Mailing Address - Country:US
Mailing Address - Phone:980-999-1216
Mailing Address - Fax:
Practice Address - Street 1:1026 JAY ST STE B205
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28208-4431
Practice Address - Country:US
Practice Address - Phone:980-999-1216
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-09-15
Last Update Date:2024-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12552124Q00000X
PA072250124Q00000X
174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No124Q00000XDental ProvidersDental Hygienist