Provider Demographics
NPI:1619036571
Name:ATKINS, DON CARLOS III (DDS)
Entity Type:Individual
Prefix:DR
First Name:DON
Middle Name:CARLOS
Last Name:ATKINS
Suffix:III
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11282 FOSTER RD
Mailing Address - Street 2:
Mailing Address - City:LOS ALAMITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90720-2922
Mailing Address - Country:US
Mailing Address - Phone:562-598-3322
Mailing Address - Fax:
Practice Address - Street 1:4440 E VILLAGE RD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-1540
Practice Address - Country:US
Practice Address - Phone:562-425-3311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA272271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice