Provider Demographics
NPI:1750820635
Name:ROBBINSVILLE ORTHODONTICS
Entity Type:Organization
Organization Name:ROBBINSVILLE ORTHODONTICS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:CELESTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:FERNANDEZ-VIVES
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:917-689-5713
Mailing Address - Street 1:1140 US HIGHWAY 130
Mailing Address - Street 2:SUITE 6
Mailing Address - City:ROBBINSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08691
Mailing Address - Country:US
Mailing Address - Phone:609-450-8890
Mailing Address - Fax:
Practice Address - Street 1:1140 US HIGHWAY 130
Practice Address - Street 2:SUITE 6
Practice Address - City:ROBBINSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08691-1137
Practice Address - Country:US
Practice Address - Phone:609-450-8890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-13
Last Update Date:2017-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22D1023141001223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty