Individual provider Active NPI

Jeffrey Glenn Robinson, D.D.S

  • General Practice Dentistry
  • Temecula, CA
National Provider Identifier
1104018753
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
D07729 Issued in AZ
Practice address
27699 Jefferson Ave Ste 306
Temecula, CA 92590-2615
Phone
(951) 506-2424
Fax
(951) 506-0604
NPI assigned
Aug 16, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 204919754 CA
General Practice Dentistry 1223G0001X D07729 AZ Primary

Addresses

Primary practice location

27699 Jefferson Ave Ste 306
Temecula, CA 92590-2615

Mailing address

4701 W Indian School Rd
Phoenix, AZ 85031-2719
Phone (623) 245-8461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D07729AZMDGeneral Practice Dentistry
204919754CAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Sleep Apnea Solutions Inc Dentist Past Accepting new patients
Squaw Peak Anesthesia Inc PastSince Nov 17, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1104018753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4701 W INDIAN SCHOOL RD",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850312719",
            "telephone_number": "623-245-8461"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27699 JEFFERSON AVE STE 306",
            "city": "TEMECULA",
            "state": "CA",
            "postal_code": "925902615",
            "telephone_number": "951-506-2424",
            "fax_number": "951-506-0604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "JEFFREY",
        "middle_name": "GLENN",
        "credential": "D.D.S",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-16",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "204919754",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D07729",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Temecula, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.