Provider Demographics
NPI:1417050667
Name:ADDINGTON, DANNY WARREN (DDS)
Entity type:Individual
Prefix:
First Name:DANNY
Middle Name:WARREN
Last Name:ADDINGTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:307 EAST HIRAM
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:TX
Mailing Address - Zip Code:75551
Mailing Address - Country:US
Mailing Address - Phone:903-796-2111
Mailing Address - Fax:903-796-5401
Practice Address - Street 1:307 EAST HIRAM
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:TX
Practice Address - Zip Code:75551
Practice Address - Country:US
Practice Address - Phone:903-796-2111
Practice Address - Fax:903-796-5401
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2011-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX143831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX090292602Medicaid