Provider Demographics
NPI:1326230327
Name:ROBERT A. WEINSTEIN, DDS, MS, PC
Entity Type:Organization
Organization Name:ROBERT A. WEINSTEIN, DDS, MS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:WEINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MS
Authorized Official - Phone:972-960-1111
Mailing Address - Street 1:14856 PRESTON RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-6822
Mailing Address - Country:US
Mailing Address - Phone:972-960-1111
Mailing Address - Fax:972-960-1110
Practice Address - Street 1:14856 PRESTON RD
Practice Address - Street 2:SUITE 104
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-6822
Practice Address - Country:US
Practice Address - Phone:972-960-1111
Practice Address - Fax:972-960-1110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-14
Last Update Date:2007-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX195901223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1396759478OtherINDIVIDUAL NPI
TX179739101Medicaid