Provider Demographics
NPI:1972516169
Name:ASAMOA, ANGELA AKASI (DMD)
Entity type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:AKASI
Last Name:ASAMOA
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:MISS
Other - First Name:ANGELA
Other - Middle Name:AKASI
Other - Last Name:KYIAMAH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:938 CHESTER PIKE
Mailing Address - Street 2:
Mailing Address - City:SHARON HILL
Mailing Address - State:PA
Mailing Address - Zip Code:19079
Mailing Address - Country:US
Mailing Address - Phone:610-586-6520
Mailing Address - Fax:610-534-9859
Practice Address - Street 1:938 CHESTER PIKE
Practice Address - Street 2:
Practice Address - City:SHARON HILL
Practice Address - State:PA
Practice Address - Zip Code:19079
Practice Address - Country:US
Practice Address - Phone:610-586-6520
Practice Address - Fax:610-534-9859
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS036025122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1011688380001Medicaid