Provider Demographics
NPI:1922109602
Name:HEINRICHS, ROBERT JEFFREY (DDS)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:JEFFREY
Last Name:HEINRICHS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:375 INDEPENDENCE DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:NAPOLEON
Mailing Address - State:OH
Mailing Address - Zip Code:43545
Mailing Address - Country:US
Mailing Address - Phone:419-592-0034
Mailing Address - Fax:419-592-5200
Practice Address - Street 1:375 INDEPENDENCE DR
Practice Address - Street 2:SUITE 110
Practice Address - City:NAPOLEON
Practice Address - State:OH
Practice Address - Zip Code:43545
Practice Address - Country:US
Practice Address - Phone:419-592-0034
Practice Address - Fax:419-592-5200
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH17858122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist