Provider Demographics
NPI:1245421643
Name:LEMBACH, ROBERT JASON (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JASON
Last Name:LEMBACH
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 1:209 MOUNTAIN RD
Mailing Address - Street 2:
Mailing Address - City:FALLSTON
Mailing Address - State:MD
Mailing Address - Zip Code:21047-2839
Mailing Address - Country:US
Mailing Address - Phone:410-877-1525
Mailing Address - Fax:410-877-1528
Practice Address - Street 1:209 MOUNTAIN RD
Practice Address - Street 2:
Practice Address - City:FALLSTON
Practice Address - State:MD
Practice Address - Zip Code:21047-2839
Practice Address - Country:US
Practice Address - Phone:410-877-1525
Practice Address - Fax:410-877-1528
Is Sole Proprietor?:No
Enumeration Date:2007-08-09
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD138521223G0001X, 122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice