Provider Demographics
NPI:1295849768
Name:I. KENT ELKINGTON, P.A.
Entity Type:Organization
Organization Name:I. KENT ELKINGTON, P.A.
Other - Org Name:SEAFORD DENTAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:KENT
Authorized Official - Last Name:ELKINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:302-629-3008
Mailing Address - Street 1:218 PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:SEAFORD
Mailing Address - State:DE
Mailing Address - Zip Code:19973-3820
Mailing Address - Country:US
Mailing Address - Phone:302-629-3008
Mailing Address - Fax:302-629-3746
Practice Address - Street 1:218 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:SEAFORD
Practice Address - State:DE
Practice Address - Zip Code:19973-3820
Practice Address - Country:US
Practice Address - Phone:302-629-3008
Practice Address - Fax:302-629-3746
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-00010051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000614208Medicaid