Provider Demographics
NPI:1790168128
Name:ROBINS, BRANDON (DMD)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:ROBINS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6634 S MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74133-2050
Mailing Address - Country:US
Mailing Address - Phone:918-872-7140
Mailing Address - Fax:918-872-7147
Practice Address - Street 1:2855 35TH AVE
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80634-9473
Practice Address - Country:US
Practice Address - Phone:970-744-4456
Practice Address - Fax:918-872-7147
Is Sole Proprietor?:No
Enumeration Date:2015-07-02
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO00204698122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist