Healthcare Provider Details

I. General information

NPI: 1801269261
Provider Name (Legal Business Name): JAMES KOLBY ROBINSON D.M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/06/2015
Last Update Date: 08/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1291 E. MCANDREWS RD.
MEDFORD OR
80238-2506
US

IV. Provider business mailing address

3840 FIELDBROOK AVE
MEDFORD OR
80238-2506
US

V. Phone/Fax

Practice location:
  • Phone: 541-779-8923
  • Fax:
Mailing address:
  • Phone: 801-808-6934
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code122300000X
TaxonomyDentist
License Number00202440
License Number StateCO
# 2
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License Number10452
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: