Provider Demographics
NPI:1598853061
Name:DURKIN, ANNA V (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANNA
Middle Name:V
Last Name:DURKIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ANNA
Other - Middle Name:V
Other - Last Name:KRASNOPEVTSEVA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1344 E MISSION RD
Mailing Address - Street 2:STE C
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-3038
Mailing Address - Country:US
Mailing Address - Phone:760-740-0070
Mailing Address - Fax:760-781-1403
Practice Address - Street 1:1344 E MISSION RD
Practice Address - Street 2:STE C
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-3038
Practice Address - Country:US
Practice Address - Phone:760-740-0070
Practice Address - Fax:760-781-1403
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA453811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice