Provider Demographics
NPI:1700900552
Name:ROBINSON, EMERSON (DDS MPH)
Entity Type:Individual
Prefix:
First Name:EMERSON
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:DDS MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 N UNIVERSITY AVE
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-1078
Mailing Address - Country:US
Mailing Address - Phone:734-763-3377
Mailing Address - Fax:734-763-3453
Practice Address - Street 1:1011 N UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-1078
Practice Address - Country:US
Practice Address - Phone:734-763-3377
Practice Address - Fax:734-763-3453
Is Sole Proprietor?:No
Enumeration Date:2007-03-19
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2901010084122300000X, 1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILH16138002OtherBCBS OF IL
MID100840OtherBCBS OF MI DENTAL
MI195816743OtherBCBS OF MI MED SURGICAL
MI195816743OtherBCBS OF MI MED SURGICAL
MIU18527Medicare UPIN