Provider Demographics
NPI:1104098714
Name:GEORGE R. RANKIN
Entity type:Organization
Organization Name:GEORGE R. RANKIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:R
Authorized Official - Last Name:RANKIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS,PA
Authorized Official - Phone:704-872-6534
Mailing Address - Street 1:PO BOX 388
Mailing Address - Street 2:
Mailing Address - City:STATESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28687-0388
Mailing Address - Country:US
Mailing Address - Phone:704-872-6534
Mailing Address - Fax:704-872-9407
Practice Address - Street 1:734 HARTNESS RD
Practice Address - Street 2:
Practice Address - City:STATESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28677-3425
Practice Address - Country:US
Practice Address - Phone:704-872-6534
Practice Address - Fax:704-872-9407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC4249122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC558357OtherUNITED CONCORDIA
NC8997227Medicaid
NC0239NOtherBC/BS
NCU41452OtherUPIN
NC14860508OtherADA
NC14860508OtherADA