Provider Demographics
NPI:1811506579
Name:ROBINSON, JASON K (DMD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:K
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:619 S BLUFF ST STE 400
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84770-3970
Mailing Address - Country:US
Mailing Address - Phone:435-628-5001
Mailing Address - Fax:435-628-5042
Practice Address - Street 1:619 S BLUFF ST STE 400
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84770-3970
Practice Address - Country:US
Practice Address - Phone:435-628-5001
Practice Address - Fax:435-628-5042
Is Sole Proprietor?:No
Enumeration Date:2020-07-29
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS042896122300000X
390200000X
UT13882474122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program