Provider Demographics
NPI:1386004661
Name:ROBINSON, BENJAMIN DAVID CLARKE
Entity Type:Individual
Prefix:MR
First Name:BENJAMIN
Middle Name:DAVID CLARKE
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 O'CONNNOR STREET
Mailing Address - Street 2:
Mailing Address - City:MENLO PARK
Mailing Address - State:CA
Mailing Address - Zip Code:94025-2632
Mailing Address - Country:US
Mailing Address - Phone:650-861-0982
Mailing Address - Fax:
Practice Address - Street 1:2239 N SCHOOL ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96819-2539
Practice Address - Country:US
Practice Address - Phone:650-861-0982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-01
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA1024431223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program