Provider Demographics
NPI:1053426023
Name:ROBINSON, BRENT M (DDS)
Entity type:Individual
Prefix:DR
First Name:BRENT
Middle Name:M
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:DONALD
Other - Middle Name:W
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:19108 33RD AVE W
Mailing Address - Street 2:STE B
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-4728
Mailing Address - Country:US
Mailing Address - Phone:206-778-1164
Mailing Address - Fax:425-771-7836
Practice Address - Street 1:19108 33RD AVE W
Practice Address - Street 2:STE B
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-4728
Practice Address - Country:US
Practice Address - Phone:206-778-1164
Practice Address - Fax:425-771-7836
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA9394122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist