Provider Demographics
NPI:1518105014
Name:ELLIOTT S DUSHKIN DDS APDC
Entity Type:Organization
Organization Name:ELLIOTT S DUSHKIN DDS APDC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ELLIOTT
Authorized Official - Middle Name:S
Authorized Official - Last Name:DUSHKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:925-671-7477
Mailing Address - Street 1:2485 HIGH SCHOOL AVE
Mailing Address - Street 2:#307
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520
Mailing Address - Country:US
Mailing Address - Phone:925-671-7477
Mailing Address - Fax:925-691-9671
Practice Address - Street 1:2485 HIGH SCHOOL AVE
Practice Address - Street 2:#307
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520
Practice Address - Country:US
Practice Address - Phone:925-671-7477
Practice Address - Fax:925-691-9671
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-22
Last Update Date:2009-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA267541223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty