Provider Demographics
NPI:1114958477
Name:RUBINO, RICHARD P (DDS)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:P
Last Name:RUBINO
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 1:46400 BENEDICT DR
Mailing Address - Street 2:SUITE 101
Mailing Address - City:STERLING
Mailing Address - State:VA
Mailing Address - Zip Code:20164-6604
Mailing Address - Country:US
Mailing Address - Phone:703-450-1408
Mailing Address - Fax:
Practice Address - Street 1:46400 BENEDICT DR
Practice Address - Street 2:SUITE 101
Practice Address - City:STERLING
Practice Address - State:VA
Practice Address - Zip Code:20164-6604
Practice Address - Country:US
Practice Address - Phone:703-450-1408
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2015-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010057971223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice