Provider Demographics
NPI:1609511096
Name:WILMOT, ASHLEY BROOKE (DMD)
Entity type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:BROOKE
Last Name:WILMOT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:104 WILLETS DR
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-3920
Mailing Address - Country:US
Mailing Address - Phone:516-640-0753
Mailing Address - Fax:
Practice Address - Street 1:1476 DEER PARK AVE
Practice Address - Street 2:
Practice Address - City:NORTH BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11703-1200
Practice Address - Country:US
Practice Address - Phone:631-474-6553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-01
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0645141223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry