Provider Demographics
NPI:1811399892
Name:BINNS, RANDOLD (DMD)
Entity Type:Individual
Prefix:
First Name:RANDOLD
Middle Name:
Last Name:BINNS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4413 OUTER DR
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34112-6762
Mailing Address - Country:US
Mailing Address - Phone:239-775-2455
Mailing Address - Fax:
Practice Address - Street 1:4413 OUTER DR
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-6762
Practice Address - Country:US
Practice Address - Phone:239-775-2455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-09-21
Last Update Date:2021-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL019029980122300000X, 1223G0001X
FLDN217111223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice