Provider Demographics
NPI:1902507411
Name:ATKINS, REBECA G (DDS)
Entity Type:Individual
Prefix:DR
First Name:REBECA
Middle Name:G
Last Name:ATKINS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:REBECA
Other - Middle Name:G
Other - Last Name:CARRANZA ATKINS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:3140 HARVARD AVE APT 1705
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75205-3733
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3140 HARVARD AVE APT 1705
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75205-3733
Practice Address - Country:US
Practice Address - Phone:210-450-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-13
Last Update Date:2023-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX396591223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice