Provider Demographics
NPI:1760438451
Name:HAWKINS, DARRELL LEON (DDS)
Entity Type:Individual
Prefix:DR
First Name:DARRELL
Middle Name:LEON
Last Name:HAWKINS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11275 E MISSISSIPPI AVE
Mailing Address - Street 2:STE #1W5
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80012-3263
Mailing Address - Country:US
Mailing Address - Phone:303-341-4663
Mailing Address - Fax:303-343-3839
Practice Address - Street 1:11275 E MISSISSIPPI AVE
Practice Address - Street 2:STE #1W5
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80012-3263
Practice Address - Country:US
Practice Address - Phone:303-341-4663
Practice Address - Fax:303-343-3839
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2015-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1047821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice