Provider Demographics
NPI:1154611887
Name:WENMAN, ROBYN M (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBYN
Middle Name:M
Last Name:WENMAN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:ROBYN
Other - Middle Name:M
Other - Last Name:GIEBLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1304 BUCKLEY RD
Mailing Address - Street 2:SUITE 203
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212
Mailing Address - Country:US
Mailing Address - Phone:315-474-1711
Mailing Address - Fax:315-474-4818
Practice Address - Street 1:1304 BUCKLEY RD
Practice Address - Street 2:SUITE 203
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13212
Practice Address - Country:US
Practice Address - Phone:315-474-1711
Practice Address - Fax:315-474-4818
Is Sole Proprietor?:No
Enumeration Date:2011-04-14
Last Update Date:2023-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY0561321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program