Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1649276155 Deactivated / Inactive NPI Female Practitioner

Dr. Robin Marguerite Su , DDS

Dentist • Upland, CA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Robin Su has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date June 21, 2005
NPI Deactivation Date March 21, 2006
Total Practice Duration ~1 Years of Practice (2005 – 2006)

Professional Overview & Biography Verified Profile Summary

Dr. Robin Su, DDS was a registered Dentist practicing in Upland, CA. Throughout an active medical career spanning 1 years, Dr. Su provided care at the practice location at 440 N MOUNTAIN AVE until profile deactivation on 2006-03-21.

Practice Location & Contact Primary Location

Practice Address

440 N Mountain Ave
Ste 116

Upland, CA 917865183

Telephone 9099853430
Fax 9099851936
Associated Practice Facility / Clinic
🏢 Stewart Wang Md Inc Facility NPI 1508119157

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist in Upland, CA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 14.4 Yrs
Regional Practice Density
52 Specialists

Practicing in Upland, CA (15331 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist Primary Specialty

NUCC Taxonomy Code: 122300000X

State License CA 36115

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID United Concordia Provider
1510728 (CA)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

2 Associated Practitioners
NPI 1871599373

Doctor of Dental Surgery

Dr. Bradley Ching , DDS

Dentist - General Practice

NPI 1871999227

Doctor of Dental Surgery

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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Updated Practice Location July 08, 2007

Registered at 440 N MOUNTAIN AVE, STE 116, UPLAND, CA 917865183 (Tel: 9099853430)

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Updated Business Mailing Address July 08, 2007

Registered at 440 N MOUNTAIN AVE, STE 116, UPLAND, CA 917865183 (Tel: 9099853430)

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Provider Name / Credentials Updated July 08, 2007

Recorded as ROBIN SU, D.D.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist (License #36115 in CA)

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NPI Profile Reactivated March 27, 2006

Record officially reactivated for active practice on March 27, 2006

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NPI Profile Deactivated March 21, 2006

Record deactivated on March 21, 2006

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Initial NPI Registration & Enumeration June 21, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1649276155
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: June 21, 2005
Last Update: July 13, 2026
Deactivation Date: March 21, 2006
Sole Proprietor: No

Mailing Address

440 N Mountain Ave, Ste 116

Upland, CA 917865183

Phone: 9099853430

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.