Provider Demographics
NPI:1164615217
Name:ROBINSON, LINDA K (RDH W LIMITED ACESS)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:K
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:RDH W LIMITED ACESS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19644 CLEAR NIGHT DRIVE
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3142
Mailing Address - Country:US
Mailing Address - Phone:541-312-3375
Mailing Address - Fax:541-388-8589
Practice Address - Street 1:19644 CLEAR NIGHT DRIVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3142
Practice Address - Country:US
Practice Address - Phone:541-312-3375
Practice Address - Fax:541-388-8589
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORH1714124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist