Provider Demographics
NPI:1124435375
Name:ROBERT S, ADKINS, DMD
Entity type:Organization
Organization Name:ROBERT S, ADKINS, DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:S
Authorized Official - Last Name:ADKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:859-278-9575
Mailing Address - Street 1:2505 LARKIN RD
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-3256
Mailing Address - Country:US
Mailing Address - Phone:859-278-9575
Mailing Address - Fax:859-278-0580
Practice Address - Street 1:2505 LARKIN RD
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-3256
Practice Address - Country:US
Practice Address - Phone:859-278-9575
Practice Address - Fax:859-278-0580
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-21
Last Update Date:2014-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100099590Medicaid