Provider Demographics
NPI:1518477751
Name:ATKINS DDS, PA
Entity Type:Organization
Organization Name:ATKINS DDS, PA
Other - Org Name:ATKINS & ANDERSON DDS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:BRADY
Authorized Official - Middle Name:R
Authorized Official - Last Name:ATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:979-846-1813
Mailing Address - Street 1:1700 CRESCENT POINTE PKWY
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-3898
Mailing Address - Country:US
Mailing Address - Phone:979-846-1813
Mailing Address - Fax:979-260-9824
Practice Address - Street 1:1700 CRESCENT POINTE PKWY
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-3898
Practice Address - Country:US
Practice Address - Phone:979-846-1813
Practice Address - Fax:979-260-9824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-10-02
Last Update Date:2021-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX205641223G0001X
TX32980261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDentalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1154841161OtherNPI
TX1730250085OtherNPI
1760969893OtherLINDSEY ATKINS NPI