Provider Demographics
NPI:1528155421
Name:HANKINS, WILLARD JR (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLARD
Middle Name:
Last Name:HANKINS
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:WILLARD
Other - Middle Name:
Other - Last Name:HANKINS
Other - Suffix:JR
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:5509 E SPRING ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-3736
Mailing Address - Country:US
Mailing Address - Phone:562-421-8206
Mailing Address - Fax:562-497-1885
Practice Address - Street 1:5509 E SPRING ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90808-3736
Practice Address - Country:US
Practice Address - Phone:562-421-8206
Practice Address - Fax:562-497-1885
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA365521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice