Provider Demographics
NPI:1508940511
Name:ROBINSON, JUDY A (DDS)
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:A
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3924 MARSHALL RD
Mailing Address - Street 2:
Mailing Address - City:KETTERING
Mailing Address - State:OH
Mailing Address - Zip Code:45429-4945
Mailing Address - Country:US
Mailing Address - Phone:937-293-6387
Mailing Address - Fax:
Practice Address - Street 1:3924 MARSHALL RD
Practice Address - Street 2:
Practice Address - City:KETTERING
Practice Address - State:OH
Practice Address - Zip Code:45429-4945
Practice Address - Country:US
Practice Address - Phone:937-293-6387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH181311223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry