Provider Demographics
NPI:1275556045
Name:ROBINSON, LARRY V (DDS)
Entity Type:Individual
Prefix:DR
First Name:LARRY
Middle Name:V
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5200 IRVINE BLVD
Mailing Address - Street 2:335
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-2013
Mailing Address - Country:US
Mailing Address - Phone:714-505-8717
Mailing Address - Fax:714-505-8711
Practice Address - Street 1:10900 WESTMINSTER AVE
Practice Address - Street 2:SUITE 5
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-4984
Practice Address - Country:US
Practice Address - Phone:714-539-9539
Practice Address - Fax:714-539-1202
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA18395122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA953628938OtherFED TAX ID