1407956931 NPI number — DR. EDWARD ROBINOVITZ DDS

Table of content: DR. EDWARD ROBINOVITZ DDS (NPI 1407956931)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407956931 NPI number — DR. EDWARD ROBINOVITZ DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROBINOVITZ
Provider First Name:
EDWARD
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1407956931
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
C/O COL SOONJA P CHOI MD
Provider Second Line Business Mailing Address:
HHC 121 GENERAL HOSPITAL BOX 232
Provider Business Mailing Address City Name:
APO
Provider Business Mailing Address State Name:
AP
Provider Business Mailing Address Postal Code:
96205-5244
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
0118227497068
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
168TH MED DET , CARIUS DENTAL CLINIC
Provider Second Line Business Practice Location Address:
UNIT 15652
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96205
Provider Business Practice Location Address Country Code:
KR
Provider Business Practice Location Address Telephone Number:
01182279153063
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  DI001165 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: DI001165 . This is a "DENTAL LICENSE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: DS081072 . This is a "DENTAL LICENSE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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