Provider Demographics
NPI:1497001432
Name:ROBINSON, ANDREA (DDS,PA)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:DDS,PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 LYNDHURST AVE
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27103-4006
Mailing Address - Country:US
Mailing Address - Phone:336-765-2921
Mailing Address - Fax:336-765-2923
Practice Address - Street 1:2900 LYNDHURST AVE
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27103-4006
Practice Address - Country:US
Practice Address - Phone:336-765-2921
Practice Address - Fax:336-765-2923
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-27
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC64621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice