Provider Demographics
NPI:1598262818
Name:JAMES KOLBY ROBINSON, DMD
Entity Type:Organization
Organization Name:JAMES KOLBY ROBINSON, DMD
Other - Org Name:TIMBER KIDS DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:J KOBLY
Authorized Official - Middle Name:ROBINSON
Authorized Official - Last Name:DMD
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:541-779-8923
Mailing Address - Street 1:1291 E MCANDREWS RD
Mailing Address - Street 2:
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97504-6103
Mailing Address - Country:US
Mailing Address - Phone:541-779-8923
Mailing Address - Fax:541-779-9620
Practice Address - Street 1:1291 E MCANDREWS RD
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-6103
Practice Address - Country:US
Practice Address - Phone:541-779-8923
Practice Address - Fax:541-779-9620
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-12
Last Update Date:2021-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500713928Medicaid