Jeffrey James Robertson

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12009818 Issued in IN

Practice address

6219 Vogel Rd Ste 103a
Evansville, IN 47715-4058

Phone

(812) 471-3726

NPI assigned

May 29, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1180396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932300035",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4049 WETHERSFIELD DR",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477258706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6219 VOGEL RD STE 103A",
            "city": "EVANSVILLE",
            "state": "IN",
            "postal_code": "477154058",
            "telephone_number": "812-471-3726"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTSON",
        "first_name": "JEFFREY",
        "middle_name": "JAMES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12009818",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Malorie Anne Roberts
• Shelby Roberts
• Tabatha Ann Roberts, NP
• Ashleigh Robertson, NP
• Jacy Robertson
• Kelli Robertson
• Violetta Robertson
• Helena Ebony Robinson-Willis
• Cierra Robinson
• Ellen Robinson, LMFT

• General Practice Dentistry in Evansville, IN
• Providers in Evansville, IN by specialty
• General Practice Dentistry in Indiana

• 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.