Provider Demographics
NPI:1588138861
Name:KUNNEKEL, ASHISH THOMAS (DDS)
Entity type:Individual
Prefix:DR
First Name:ASHISH
Middle Name:THOMAS
Last Name:KUNNEKEL
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 1:2200 1ST ST APT 1712
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-3426
Mailing Address - Country:US
Mailing Address - Phone:720-835-7699
Mailing Address - Fax:
Practice Address - Street 1:780 SCENIC DR
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-4304
Practice Address - Country:US
Practice Address - Phone:575-437-8994
Practice Address - Fax:575-446-0039
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-19
Last Update Date:2019-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD5036122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist