Provider Demographics
NPI:1013126366
Name:LEWIS, ROBERT ERROL (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:ERROL
Last Name:LEWIS
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 1:6711 75TH ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLE VILLAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11379-2630
Mailing Address - Country:US
Mailing Address - Phone:718-326-1212
Mailing Address - Fax:718-894-6132
Practice Address - Street 1:6711 75TH ST
Practice Address - Street 2:
Practice Address - City:MIDDLE VILLAGE
Practice Address - State:NY
Practice Address - Zip Code:11379-2630
Practice Address - Country:US
Practice Address - Phone:718-326-1212
Practice Address - Fax:718-894-6132
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0245471223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice