Individual provider Active NPI

Andrew C. Robinson, D.D.S

  • Dentist
  • Chinle, AZ
National Provider Identifier
1114049467
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN012945 Issued in GA
Practice address
Off Hwy 191 Hospital Road
Chinle, AZ 86503
Phone
(928) 674-7001
Fax
(928) 674-7705
NPI assigned
Apr 6, 2007
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN012945 GA Primary

Addresses

Primary practice location

Off Hwy 191 Hospital Road
Chinle, AZ 86503

Mailing address

PO Drawer PH
Chinle, AZ 86503
Phone (928) 674-7001

Other identifiers 1

IdentifierTypeStateIssuer
115133MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160408000146 TX Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 3971801945

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1114049467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO DRAWER PH",
            "city": "CHINLE",
            "state": "AZ",
            "postal_code": "86503",
            "telephone_number": "928-674-7001",
            "fax_number": "928-674-7705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "OFF HWY 191 HOSPITAL ROAD",
            "city": "CHINLE",
            "state": "AZ",
            "postal_code": "86503",
            "telephone_number": "928-674-7001",
            "fax_number": "928-674-7705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "ANDREW",
        "middle_name": "C.",
        "name_prefix": "Mr.",
        "credential": "D.D.S",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN012945",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "115133",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Chinle, AZ

Sources for this page

Verify at the official NPI Registry.