Provider Demographics
NPI:1508161902
Name:KIPPELMAN, ROBERT STEPHEN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:STEPHEN
Last Name:KIPPELMAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 N.E. 4TH AVENUE
Mailing Address - Street 2:SUITE 5
Mailing Address - City:DELRAY BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33483-4565
Mailing Address - Country:US
Mailing Address - Phone:561-276-6662
Mailing Address - Fax:561-243-1666
Practice Address - Street 1:74 N.E. 4TH AVENUE
Practice Address - Street 2:SUITE 5
Practice Address - City:DELRAY BEACH
Practice Address - State:FL
Practice Address - Zip Code:33483-4565
Practice Address - Country:US
Practice Address - Phone:561-276-6662
Practice Address - Fax:561-243-1666
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-14
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11293122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist