Provider Demographics
NPI:1518208131
Name:MERIN, ROBERT L (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:L
Last Name:MERIN
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 1:6342 FALLBROOK AVE
Mailing Address - Street 2:101
Mailing Address - City:WOODLAND HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91367-1613
Mailing Address - Country:US
Mailing Address - Phone:818-887-7772
Mailing Address - Fax:818-887-2231
Practice Address - Street 1:6342 FALLBROOK AVE
Practice Address - Street 2:101
Practice Address - City:WOODLAND HILLS
Practice Address - State:CA
Practice Address - Zip Code:91367-1613
Practice Address - Country:US
Practice Address - Phone:818-887-7772
Practice Address - Fax:818-887-2231
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21388122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist