Provider Demographics
NPI:1386847424
Name:ROBERT S. DON, D.D.S., INC.
Entity Type:Organization
Organization Name:ROBERT S. DON, D.D.S., INC.
Other - Org Name:JAMBOREE DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:DON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-222-0296
Mailing Address - Street 1:62 CORPORATE PARK
Mailing Address - Street 2:SUITE 230
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92606-3122
Mailing Address - Country:US
Mailing Address - Phone:949-222-0296
Mailing Address - Fax:949-222-1110
Practice Address - Street 1:62 CORPORATE PARK
Practice Address - Street 2:SUITE 230
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92606-3122
Practice Address - Country:US
Practice Address - Phone:949-222-0296
Practice Address - Fax:949-222-1110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2009-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA439401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty