Provider Demographics
NPI:1811316086
Name:JAY C. ADKINS, DDS
Entity type:Organization
Organization Name:JAY C. ADKINS, DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:JAY
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:806-793-3556
Mailing Address - Street 1:5301 50TH ST STE 100
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79414-5834
Mailing Address - Country:US
Mailing Address - Phone:806-793-3556
Mailing Address - Fax:
Practice Address - Street 1:5301 50TH ST STE 100
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79414-5834
Practice Address - Country:US
Practice Address - Phone:806-793-3556
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-15
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27872122300000X
TX13055122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty