Provider Demographics
NPI:1700987641
Name:ROBINSON, DONALD CHARLES JR (DDS)
Entity Type:Individual
Prefix:MR
First Name:DONALD
Middle Name:CHARLES
Last Name:ROBINSON
Suffix:JR
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 1:3709 KECOUGHTAN ROAD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-4405
Mailing Address - Country:US
Mailing Address - Phone:757-722-8507
Mailing Address - Fax:757-722-6858
Practice Address - Street 1:3709 KECOUGHTAN ROAD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669-4405
Practice Address - Country:US
Practice Address - Phone:757-722-8507
Practice Address - Fax:757-722-6858
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2020-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA6982122300000X
VA04010069821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
049114OtherBCBS
834168OtherUNITED CONCORDIA
VA7803567Medicaid