Provider Demographics
NPI:1528148392
Name:ROBINSON, QUINTON CARTY III (DDS)
Entity type:Individual
Prefix:DR
First Name:QUINTON
Middle Name:CARTY
Last Name:ROBINSON
Suffix:III
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 1:5180 PARK AVE
Mailing Address - Street 2:SUITE 260
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38119-3521
Mailing Address - Country:US
Mailing Address - Phone:901-683-6770
Mailing Address - Fax:901-766-1640
Practice Address - Street 1:5180 PARK AVE
Practice Address - Street 2:SUITE 260
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38119-3521
Practice Address - Country:US
Practice Address - Phone:901-683-6770
Practice Address - Fax:901-766-1640
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2013-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDS00000043291223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ000893Medicaid
TN3225510Medicaid