Provider Demographics
NPI:1124612874
Name:HICKS, ASHLEY MARIA (RDH)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:MARIA
Last Name:HICKS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:MRS
Other - First Name:ASHLEY
Other - Middle Name:MARIA
Other - Last Name:HICKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ASHLEY WEEDEN, RDH
Mailing Address - Street 1:18373 E ARKANSAS AVE
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80017-4312
Mailing Address - Country:US
Mailing Address - Phone:205-370-9898
Mailing Address - Fax:
Practice Address - Street 1:130957 S PARKER RD.
Practice Address - Street 2:
Practice Address - City:PARKER
Practice Address - State:CO
Practice Address - Zip Code:80134
Practice Address - Country:US
Practice Address - Phone:205-370-9898
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-02-23
Last Update Date:2021-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO002025918124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALNAMedicaid