Healthcare Provider Details

I. General information

NPI: 1902017635
Provider Name (Legal Business Name): JOHN A ROBINA DMD, FAGD, PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 WOODLAND AVE
SUMMIT NJ
07901-2112
US

IV. Provider business mailing address

55 WOODLAND AVE
SUMMIT NJ
07901-2112
US

V. Phone/Fax

Practice location:
  • Phone: 908-273-1200
  • Fax:
Mailing address:
  • Phone: 908-273-1200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number22DI02007700
License Number StateNJ

VIII. Authorized Official

Name: DR. JOHN A ROBINA
Title or Position: DENTIST
Credential: DMD
Phone: 908-273-1200