Individual provider Active NPI

Murray Ralph Robinovitch, D.D.S.

  • Periodontics
  • Mount Vernon, WA
National Provider Identifier
1477567378
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PeriodonticsTaxonomy code 1223P0300X
License
DE00004887 Issued in WA
Practice address
2210 Kulshan View Dr Ste 105
Mount Vernon, WA 98273-2779
Phone
(360) 424-5175
NPI assigned
Jul 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Periodontics 1223P0300X DE00004887 WA Primary

Addresses

Primary practice location

2210 Kulshan View Dr Ste 105
Mount Vernon, WA 98273-2779

Mailing address

11831 Bayview Edison Rd
Mount Vernon, WA 98273-8226
Phone (360) 707-5556

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
DE00004887WAMDPeriodontist

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1477567378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11831 BAYVIEW EDISON RD",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982738226",
            "telephone_number": "360-707-5556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2210 KULSHAN VIEW DR STE 105",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982732779",
            "telephone_number": "360-424-5175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINOVITCH",
        "first_name": "MURRAY",
        "middle_name": "RALPH",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "WA",
            "license": "DE00004887",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Vernon, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.