Healthcare Provider Details

I. General information

NPI: 1003596115
Provider Name (Legal Business Name): CEANNA C ROBINSON-WILEY DMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2023
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27 CHURCH HILL RD
NEWTOWN CT
06470-1612
US

IV. Provider business mailing address

27 CHURCH HILL RD
NEWTOWN CT
06470-1612
US

V. Phone/Fax

Practice location:
  • Phone: 203-426-3310
  • Fax:
Mailing address:
  • Phone: 203-426-3310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number14799
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: