Healthcare Provider Details

I. General information

NPI: 1730014408
Provider Name (Legal Business Name): KIRBY J. ROBINSON, DDS OF MISSOURI, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2026
Last Update Date: 06/15/2026
Certification Date: 06/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

157 SIEMERS DR STE 106
CAPE GIRARDEAU MO
63701-4920
US

IV. Provider business mailing address

157 SIEMERS DR STE 106
CAPE GIRARDEAU MO
63701-4920
US

V. Phone/Fax

Practice location:
  • Phone: 573-335-5199
  • Fax:
Mailing address:
  • Phone: 573-335-5199
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: HALEY WOOSTER
Title or Position: CREDENTIALING MANAGER
Credential:
Phone: 984-251-8846