Provider Demographics
NPI:1457531659
Name:KIRBY JOE ROBINSON OF TEXAS, DDS, P.C.
Entity Type:Organization
Organization Name:KIRBY JOE ROBINSON OF TEXAS, DDS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:KENNEDY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:800-658-2177
Mailing Address - Street 1:5740 SW GREEN OAKS BLVD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-1201
Mailing Address - Country:US
Mailing Address - Phone:817-583-5615
Mailing Address - Fax:
Practice Address - Street 1:5740 SW GREEN OAKS BLVD
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-1201
Practice Address - Country:US
Practice Address - Phone:817-583-5615
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0016454122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty