Provider Demographics
NPI:1477093425
Name:ROBINSON, HAROLD LINCOLN III (DMD)
Entity Type:Individual
Prefix:DR
First Name:HAROLD
Middle Name:LINCOLN
Last Name:ROBINSON
Suffix:III
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 W FILLMORE ST APT 421
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85003-0026
Mailing Address - Country:US
Mailing Address - Phone:484-467-1036
Mailing Address - Fax:
Practice Address - Street 1:7006 S CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85042-5423
Practice Address - Country:US
Practice Address - Phone:602-276-1029
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-23
Last Update Date:2020-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZD0103141223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ592243Medicaid