Provider Demographics
NPI:1255431680
Name:RIGGS, ROBERT J (DDS MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:J
Last Name:RIGGS
Suffix:
Gender:M
Credentials:DDS MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2708 HENRY ST
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405
Mailing Address - Country:US
Mailing Address - Phone:336-621-1554
Mailing Address - Fax:336-621-1554
Practice Address - Street 1:2708 HENRY ST
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405
Practice Address - Country:US
Practice Address - Phone:336-621-1554
Practice Address - Fax:336-621-1554
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC69401223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC899008RMedicaid
NC89115OXMedicaid
190010222OtherRAILROAD MEDICARE
NC11SOXOtherBCBS
NC115OXOtherBCBS
NC2428782AMedicare ID - Type Unspecified
NC899008RMedicaid