Provider Demographics
NPI:1396974630
Name:LIPSEY, ROBERT DANA (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:DANA
Last Name:LIPSEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3705 MEADOWLARK LN
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-8038
Mailing Address - Country:US
Mailing Address - Phone:317-858-3894
Mailing Address - Fax:
Practice Address - Street 1:737 MOON RD
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IN
Practice Address - Zip Code:46168-8757
Practice Address - Country:US
Practice Address - Phone:317-839-7727
Practice Address - Fax:317-837-9468
Is Sole Proprietor?:No
Enumeration Date:2009-07-08
Last Update Date:2009-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12008978A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist