Provider Demographics
NPI:1184870065
Name:BAGBY, ROBIN ELIZABETH (DDS)
Entity type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:ELIZABETH
Last Name:BAGBY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:ELIZABETH
Other - Last Name:HINRICHS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:4102 ELECTRIC RD.
Mailing Address - Street 2:BLUE RIDGE ENDODONTICS
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24018
Mailing Address - Country:US
Mailing Address - Phone:540-772-9515
Mailing Address - Fax:540-772-0716
Practice Address - Street 1:4102 ELECTRIC RD
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24018-0614
Practice Address - Country:US
Practice Address - Phone:540-772-9515
Practice Address - Fax:540-772-0716
Is Sole Proprietor?:No
Enumeration Date:2008-08-12
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA04010089871223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics