Healthcare Provider Details

I. General information

NPI: 1285842955
Provider Name (Legal Business Name): ROBERT IRVING STOCKTON D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 03/27/2026
Certification Date: 03/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

223 W IRONWOOD DR
COEUR D ALENE ID
83814-2651
US

IV. Provider business mailing address

223 W IRONWOOD DR
COEUR D ALENE ID
83814-2651
US

V. Phone/Fax

Practice location:
  • Phone: 208-277-9321
  • Fax:
Mailing address:
  • Phone: 208-277-9321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number5763
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License NumberD10151
License Number StateOR
# 3
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License NumberD-1808
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: