Healthcare Provider Details

I. General information

NPI: 1801190475
Provider Name (Legal Business Name): QUIANA ROBINSON D.D.S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: QUIANA J REID DDS

II. Dates (important events)

Enumeration Date: 12/22/2010
Last Update Date: 10/08/2020
Certification Date: 10/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5301 WILKINSON BLVD # 1105
CHARLOTTE NC
28208-5455
US

IV. Provider business mailing address

5301 WILKINSON BLVD # 1105
CHARLOTTE NC
28208-5455
US

V. Phone/Fax

Practice location:
  • Phone: 704-316-6561
  • Fax:
Mailing address:
  • Phone: 704-316-6561
  • Fax: 704-384-1977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number9133
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: