Provider Demographics
NPI:1700294469
Name:ROBISON, SLOAN (DMD)
Entity type:Individual
Prefix:DR
First Name:SLOAN
Middle Name:
Last Name:ROBISON
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 1:11225 EMERALD PINE LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89138-1589
Mailing Address - Country:US
Mailing Address - Phone:801-300-5067
Mailing Address - Fax:
Practice Address - Street 1:605 OLD BALLAS RD STE 118
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63141-7070
Practice Address - Country:US
Practice Address - Phone:801-300-5067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-25
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV7337122300000X
CODEN.00202304122300000X
MO2500075993122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist