Provider Demographics
NPI:1982608626
Name:DOCKINS, DEEANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:DEEANN
Middle Name:
Last Name:DOCKINS
Suffix:
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 1:2110 N GALLOWAY AVE
Mailing Address - Street 2:STE 120
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-5738
Mailing Address - Country:US
Mailing Address - Phone:972-289-5563
Mailing Address - Fax:972-329-5039
Practice Address - Street 1:149 COUNTRY CLUB
Practice Address - Street 2:
Practice Address - City:HEATH
Practice Address - State:TX
Practice Address - Zip Code:75032
Practice Address - Country:US
Practice Address - Phone:972-289-5563
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX141781223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice