Provider Demographics
NPI:1053706036
Name:DAVE, ASHUMI (DMD)
Entity type:Individual
Prefix:
First Name:ASHUMI
Middle Name:
Last Name:DAVE
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 HOWLAND AVE
Mailing Address - Street 2:
Mailing Address - City:RIVER EDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07661-1820
Mailing Address - Country:US
Mailing Address - Phone:917-620-1401
Mailing Address - Fax:
Practice Address - Street 1:79 E MADISON AVE
Practice Address - Street 2:
Practice Address - City:DUMONT
Practice Address - State:NJ
Practice Address - Zip Code:07628
Practice Address - Country:US
Practice Address - Phone:201-546-5800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-06
Last Update Date:2018-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0594361223G0001X
NJ22DI026316001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice