Provider Demographics
NPI:1356445654
Name:ELKINGTON, ISAAC KENT (DDS)
Entity Type:Individual
Prefix:DR
First Name:ISAAC
Middle Name:KENT
Last Name:ELKINGTON
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 1:218 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
Is Sole Proprietor?:No
Enumeration Date:2006-09-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEG1-00010051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE0000614208Medicaid