Provider Demographics
NPI:1780647404
Name:LUEBKE, ROBERT JOHN (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOHN
Last Name:LUEBKE
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 DENBIGH DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-4909
Mailing Address - Country:US
Mailing Address - Phone:319-351-8836
Mailing Address - Fax:
Practice Address - Street 1:601 HIGHWAY 6 W
Practice Address - Street 2:DENTAL SERVICE (160), VAMC
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52246-2292
Practice Address - Country:US
Practice Address - Phone:319-339-7160
Practice Address - Fax:319-339-7191
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA057041223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics