Provider Demographics
NPI:1669671756
Name:LARRY V ROBINSON, D.D.S., INC.
Entity Type:Organization
Organization Name:LARRY V ROBINSON, D.D.S., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LARRY
Authorized Official - Middle Name:VERLIN
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:714-505-8717
Mailing Address - Street 1:5200 IRVINE BLVD
Mailing Address - Street 2:335
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-2013
Mailing Address - Country:US
Mailing Address - Phone:714-505-8717
Mailing Address - Fax:714-505-8711
Practice Address - Street 1:5200 IRVINE BLVD
Practice Address - Street 2:335
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-2013
Practice Address - Country:US
Practice Address - Phone:714-505-8717
Practice Address - Fax:714-505-8711
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-17
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA5540261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental