Provider Demographics
NPI:1649201237
Name:ROBINSON, JOSEPH P JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:P
Last Name:ROBINSON
Suffix:JR
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 1:610 MILLER BVD
Mailing Address - Street 2:
Mailing Address - City:HAVELOCK
Mailing Address - State:NC
Mailing Address - Zip Code:28532-0942
Mailing Address - Country:US
Mailing Address - Phone:252-447-1135
Mailing Address - Fax:252-447-6956
Practice Address - Street 1:610 MILLER BLVD
Practice Address - Street 2:
Practice Address - City:HAVELOCK
Practice Address - State:NC
Practice Address - Zip Code:28532-2952
Practice Address - Country:US
Practice Address - Phone:252-447-1135
Practice Address - Fax:252-447-6956
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC38241223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC20043OtherUNITED CONCORDIA PROVIDER
NC0284WOtherBLUE CROSS BLUE SHIELD