Provider Demographics
NPI:1497807705
Name:DURBIN, DENNIS SCOTT (DC)
Entity Type:Individual
Prefix:
First Name:DENNIS
Middle Name:SCOTT
Last Name:DURBIN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 KINGSTON ST
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626
Mailing Address - Country:US
Mailing Address - Phone:714-376-7827
Mailing Address - Fax:714-241-9197
Practice Address - Street 1:17975 SKYPARK CIRCLE
Practice Address - Street 2:STE C
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614
Practice Address - Country:US
Practice Address - Phone:949-263-0270
Practice Address - Fax:949-263-0281
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC25856111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor