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General NPI Number Information
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NPI Number | 1144959859
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Entity Type | Individual
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Provider Name | CHAD ROBINSON
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Gender | Male
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Dates
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Enumeration Date | 06/08/2022
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Last Update Date | 01/06/2026
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Provider Practice Location Address
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Address Line | 1516 NE 96TH ST
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City | LIBERTY
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State | MO
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Zip | 64068-1348
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Country | US
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Telephone | 816-741-1155
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Fax |
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Provider Business Mailing Address
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Address Line | 1516 NE 96TH ST
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City | LIBERTY
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State | MO
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Zip | 64068-1348
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Country | US
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Telephone | 816-741-1155
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 10198
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 2025029357
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License Number State | MO
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