Provider Demographics
NPI:1871732974
Name:ROBINSON, REBECCA LYNN (DDS)
Entity type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:LYNN
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:REBECCA
Other - Middle Name:
Other - Last Name:LOEWEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:2177 LAS POSITAS CT
Mailing Address - Street 2:
Mailing Address - City:LIVERMORE
Mailing Address - State:CA
Mailing Address - Zip Code:94551-8872
Mailing Address - Country:US
Mailing Address - Phone:925-273-6016
Mailing Address - Fax:
Practice Address - Street 1:2177 LAS POSITAS CT
Practice Address - Street 2:
Practice Address - City:LIVERMORE
Practice Address - State:CA
Practice Address - Zip Code:94551-8872
Practice Address - Country:US
Practice Address - Phone:925-273-6016
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-12
Last Update Date:2024-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO9844122300000X
CA57782122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO65204735Medicaid