Provider Demographics
NPI:1396273017
Name:ALBERT, ASHLON WALDEL (DDS)
Entity type:Individual
Prefix:DR
First Name:ASHLON
Middle Name:WALDEL
Last Name:ALBERT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1021 W 23RD ST UNIT C
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77008-1980
Mailing Address - Country:US
Mailing Address - Phone:225-445-7464
Mailing Address - Fax:
Practice Address - Street 1:3535 CLEAR LAKE CITY BLVD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77059
Practice Address - Country:US
Practice Address - Phone:832-224-2816
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-24
Last Update Date:2018-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX34552122300000X
LA6740122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist