Provider Demographics
NPI:1992952154
Name:ROBINSON, MARY CARTER (DDS)
Entity type:Individual
Prefix:DR
First Name:MARY
Middle Name:CARTER
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:MARY
Other - Middle Name:LUELLA
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:1150 RIPLEY ST
Mailing Address - Street 2:#1116
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20910-3475
Mailing Address - Country:US
Mailing Address - Phone:615-202-8076
Mailing Address - Fax:
Practice Address - Street 1:6201 GREENBELT RD.
Practice Address - Street 2:SUITE M-1
Practice Address - City:COLLEGE PARK
Practice Address - State:MD
Practice Address - Zip Code:20740
Practice Address - Country:US
Practice Address - Phone:301-345-7007
Practice Address - Fax:301-345-5288
Is Sole Proprietor?:No
Enumeration Date:2008-08-19
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK1591223S0112X
CA600911223S0112X
MD155591223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK200346450AMedicaid