Provider Demographics
NPI:1073508834
Name:WEINER IVKER, ROBYN ELIZABETH (DMD)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:ELIZABETH
Last Name:WEINER IVKER
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:821 S PENN OAK RD
Mailing Address - Street 2:
Mailing Address - City:LOWER GWYNEDD
Mailing Address - State:PA
Mailing Address - Zip Code:19002-1953
Mailing Address - Country:US
Mailing Address - Phone:267-808-4446
Mailing Address - Fax:
Practice Address - Street 1:519 BALTIMORE PIKE
Practice Address - Street 2:
Practice Address - City:CHADDS FORD
Practice Address - State:PA
Practice Address - Zip Code:19317
Practice Address - Country:US
Practice Address - Phone:717-295-4400
Practice Address - Fax:215-743-3706
Is Sole Proprietor?:No
Enumeration Date:2005-09-16
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-031556-L1223P0221X
PADS031556L1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001962580Medicaid