Provider Demographics
NPI:1275662736
Name:DUSHKIN, ELLIOTT STEVEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELLIOTT
Middle Name:STEVEN
Last Name:DUSHKIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:ELLIOTT
Other - Middle Name:STEVEN
Other - Last Name:DUSHKIN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:2500 ALHAMBRA AVENUE
Mailing Address - Street 2:CONTRA COSTA COUNTY REGIONAL HEALTH CENTER
Mailing Address - City:MARTINEZ
Mailing Address - State:CA
Mailing Address - Zip Code:94553-3191
Mailing Address - Country:US
Mailing Address - Phone:925-671-7477
Mailing Address - Fax:925-691-9671
Practice Address - Street 1:2500 ALHAMBRA AVENUE
Practice Address - Street 2:CONTRA COSTA COUNTY REGIONAL HEALTH CENTER
Practice Address - City:MARTINEZ
Practice Address - State:CA
Practice Address - Zip Code:94553-3191
Practice Address - Country:US
Practice Address - Phone:925-671-7477
Practice Address - Fax:925-691-9671
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA267541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice