Provider Demographics
NPI:1811564990
Name:ROBERT, EMILY ANN (DDS)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:ANN
Last Name:ROBERT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 DOGWOOD DR
Mailing Address - Street 2:
Mailing Address - City:KENNER
Mailing Address - State:LA
Mailing Address - Zip Code:70065-6634
Mailing Address - Country:US
Mailing Address - Phone:504-952-5080
Mailing Address - Fax:
Practice Address - Street 1:2301 WILLIAMS BLVD
Practice Address - Street 2:
Practice Address - City:KENNER
Practice Address - State:LA
Practice Address - Zip Code:70062-5825
Practice Address - Country:US
Practice Address - Phone:504-467-2333
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-08
Last Update Date:2021-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA72141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty