Provider Demographics
NPI:1962078022
Name:KEESLER, ASHLEY CHEN (DDS)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:CHEN
Last Name:KEESLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ASHLEY
Other - Middle Name:
Other - Last Name:CHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:512 66TH AVE N
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN CENTER
Mailing Address - State:MN
Mailing Address - Zip Code:55430-1643
Mailing Address - Country:US
Mailing Address - Phone:763-560-3334
Mailing Address - Fax:
Practice Address - Street 1:512 66TH AVE N
Practice Address - Street 2:
Practice Address - City:BROOKLYN CENTER
Practice Address - State:MN
Practice Address - Zip Code:55430-1643
Practice Address - Country:US
Practice Address - Phone:763-560-3334
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-31
Last Update Date:2023-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX377181223G0001X
390200000X
MND148661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program