Provider Demographics
NPI:1548953557
Name:HILLOCK, ASHLEY LYNETTE (DMD)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:LYNETTE
Last Name:HILLOCK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2211 SUNWEST DR
Mailing Address - Street 2:
Mailing Address - City:LODI
Mailing Address - State:CA
Mailing Address - Zip Code:95242-3714
Mailing Address - Country:US
Mailing Address - Phone:209-817-2665
Mailing Address - Fax:
Practice Address - Street 1:1908 COFFEE RD
Practice Address - Street 2:
Practice Address - City:MODESTO
Practice Address - State:CA
Practice Address - Zip Code:95355-2719
Practice Address - Country:US
Practice Address - Phone:209-522-8800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA1088181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice