Provider Demographics
NPI:1285726133
Name:JENNINGS, ROBIN H (RDH)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:H
Last Name:JENNINGS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:LECIA
Other - Last Name:HARRISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BSHS
Mailing Address - Street 1:1329 JEFFERSON STREET
Mailing Address - Street 2:
Mailing Address - City:BOYDTON
Mailing Address - State:VA
Mailing Address - Zip Code:23917
Mailing Address - Country:US
Mailing Address - Phone:434-738-0731
Mailing Address - Fax:434-738-0536
Practice Address - Street 1:1329 JEFFERSON STREET
Practice Address - Street 2:
Practice Address - City:BOYDTON
Practice Address - State:VA
Practice Address - Zip Code:23917
Practice Address - Country:US
Practice Address - Phone:434-738-6102
Practice Address - Fax:434-738-6982
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0402002981124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist