Healthcare Provider Details

I. General information

NPI: 1528286952
Provider Name (Legal Business Name): MELANIE DANIELLE ROBINSON DDS, MS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/23/2007
Last Update Date: 10/09/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3305 NORTHLAND DR STE 204
AUSTIN TX
78731-5011
US

IV. Provider business mailing address

3305 NORTHLAND DR STE 204
AUSTIN TX
78731-5011
US

V. Phone/Fax

Practice location:
  • Phone: 512-377-5656
  • Fax: 512-377-5657
Mailing address:
  • Phone: 512-377-5656
  • Fax: 512-377-5657

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0300X
TaxonomyPeriodontics
License Number20553
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: