Provider Demographics
NPI:1194301226
Name:ASHLEY DAWSON, DDS, PLLC
Entity type:Organization
Organization Name:ASHLEY DAWSON, DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:RENEA
Authorized Official - Last Name:DAWSON-SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:678-735-0660
Mailing Address - Street 1:3314 MAYFIELD AVE
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28209-1821
Mailing Address - Country:US
Mailing Address - Phone:678-735-0660
Mailing Address - Fax:
Practice Address - Street 1:3555 MATTHEWS MINT HILL RD STE 2
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-4174
Practice Address - Country:US
Practice Address - Phone:678-735-0660
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-19
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty