Provider Demographics
NPI:1588893606
Name:NILES, ASHLEY MOORE (DDS)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:MOORE
Last Name:NILES
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:136 2ND AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:NIWOT
Mailing Address - State:CO
Mailing Address - Zip Code:80544-5030
Mailing Address - Country:US
Mailing Address - Phone:303-652-0400
Mailing Address - Fax:
Practice Address - Street 1:136 2ND AVE STE 101
Practice Address - Street 2:
Practice Address - City:NIWOT
Practice Address - State:CO
Practice Address - Zip Code:80544-5030
Practice Address - Country:US
Practice Address - Phone:303-652-0400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-10
Last Update Date:2021-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO10318122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist