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Deactivated NPI 1629049317 Deactivated / Inactive NPI Male Practitioner

Dr. Robert Corley Tollefson , DDS

Dentist - General Practice • Lackland Afb, TX

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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. Robert Tollefson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 30, 2006
NPI Deactivation Date January 30, 2025
Total Practice Duration ~19 Years of Practice (2006 – 2025)

Professional Overview & Biography Verified Profile Summary

Dr. Robert Tollefson, DDS was a registered Dentist - General Practice practicing in Lackland Afb, TX. Throughout an active medical career spanning 19 years, Dr. Tollefson provided care at the practice location at 220 BERQUIST DRIVE until profile deactivation on 2025-01-30.

Practice Location & Contact Primary Location

Practice Address

220 Berquist Drive
Suite 1

Lackland Afb, TX 782365300

Telephone 2102927282

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Lackland Afb, TX

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 12.3 Yrs
Regional Practice Density
6 Specialists

Practicing in Lackland Afb, TX (10570 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 - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License TX 11142

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

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

1 Associated Practitioners
Dr. Richard Rutledge , DDS

Dentist - Endodontics

NPI 1669444964

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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NPI Profile Deactivated January 30, 2025

Record deactivated on January 30, 2025

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 220 BERQUIST DRIVE, SUITE 1, LACKLAND AFB, TX 782365300 (Tel: 2102927282)

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Updated Business Mailing Address July 08, 2007

Registered at 810 TOEPPERWEIN RD, CONVERSE, TX 781092306 (Tel: 4099632725)

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Provider Name / Credentials Updated July 08, 2007

Recorded as ROBERT TOLLEFSON, D.D.S.

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

Dentist (License #11142 in TX)

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Initial NPI Registration & Enumeration January 30, 2006

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: 1629049317
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: January 30, 2006
Last Update: July 08, 2007
Deactivation Date: January 30, 2025

Mailing Address

810 Toepperwein Rd

Converse, TX 781092306

Phone: 4099632725

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.