Provider Demographics
NPI:1053701771
Name:ROSENBAUM, ASHLEY LYNN (DMD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:LYNN
Last Name:ROSENBAUM
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:ASHLEY
Other - Middle Name:LYNN
Other - Last Name:HEBERT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:41 SE 5TH ST APT 2409
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33131-2551
Mailing Address - Country:US
Mailing Address - Phone:808-258-3398
Mailing Address - Fax:
Practice Address - Street 1:41 SE 5TH ST APT 2409
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33131-2551
Practice Address - Country:US
Practice Address - Phone:808-258-3398
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-02
Last Update Date:2015-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN210251223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry