Healthcare Provider Details

I. General information

NPI: 1194762443
Provider Name (Legal Business Name): GEORGE W EKINS DDS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21700 GOLDEN TRIANGLE RD #201
SAUGUS CA
91350-2616
US

IV. Provider business mailing address

21700 GOLDEN TRIANGLE RD #201
SAUGUS CA
91350-2616
US

V. Phone/Fax

Practice location:
  • Phone: 661-259-5540
  • Fax: 661-259-5571
Mailing address:
  • Phone: 661-259-5540
  • Fax: 661-259-5571

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number18821
License Number StateCA

VIII. Authorized Official

Name: DR. GEORGE WARREN EKINS
Title or Position: PRESIDENT
Credential: DDS
Phone: 661-259-5540