Healthcare Provider Details

I. General information

NPI: 1568256014
Provider Name (Legal Business Name): ANDREW CALEB ROBINSON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/08/2025
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3695 STAR RANCH RD
COLORADO SPRINGS CO
80906-5980
US

IV. Provider business mailing address

945 RESOLUTION PT APT 125
COLORADO SPRINGS CO
80907-7365
US

V. Phone/Fax

Practice location:
  • Phone: 719-597-7979
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDEN.00206616
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: