Provider Demographics
NPI:1295140093
Name:ELKINS, KATHRYN (DMD)
Entity type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:
Last Name:ELKINS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6057 EAGLES REST TRL
Mailing Address - Street 2:
Mailing Address - City:SUGAR HILL
Mailing Address - State:GA
Mailing Address - Zip Code:30518-8156
Mailing Address - Country:US
Mailing Address - Phone:770-617-2029
Mailing Address - Fax:
Practice Address - Street 1:12685 CRABAPPLE RD
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-6339
Practice Address - Country:US
Practice Address - Phone:770-475-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-01
Last Update Date:2022-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN014804122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist