Provider Demographics
NPI:1437271384
Name:EKINS, GEORGE WARREN (DDS)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:WARREN
Last Name:EKINS
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 1:21700 W GOLDEN TRIANGLE RD
Mailing Address - Street 2:#201
Mailing Address - City:SAUGUS
Mailing Address - State:CA
Mailing Address - Zip Code:91350
Mailing Address - Country:US
Mailing Address - Phone:661-259-5540
Mailing Address - Fax:661-259-5571
Practice Address - Street 1:21700 W GOLDEN TRIANGLE RD
Practice Address - Street 2:#201
Practice Address - City:SAUGUS
Practice Address - State:CA
Practice Address - Zip Code:91350
Practice Address - Country:US
Practice Address - Phone:661-259-5540
Practice Address - Fax:661-259-5571
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA18821122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist