Provider Demographics
NPI:1043385313
Name:RANKIN, GEORGE R (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:R
Last Name:RANKIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:734 HARTNESS ROAD
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28677
Mailing Address - Country:US
Mailing Address - Phone:704-872-6534
Mailing Address - Fax:704-872-9407
Practice Address - Street 1:734 HARTNESS ROAD
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677
Practice Address - Country:US
Practice Address - Phone:704-872-6534
Practice Address - Fax:704-872-9407
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4249122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
14860508OtherADA NUMBER
NC0997227Medicaid
NC0997227Medicaid
AR2727088OtherDEA NUMBER