Johnson, Dennis Douglas
Johnson, Dennis Douglas is an individual health care provider with primary practice located at 410 Lancaster Dr Ne Suite A, Salem OR 97301-4794. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Johnson, Dennis Douglas can be contacted via phone (503) 581-9419.Contact Information
Primary practice address
410 Lancaster Dr Ne Suite A
Salem OR 97301-4794
Phone: (503) 581-9419
Fax: (503) 581-0438
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | D4839 | Oregon |
Profile Details
| NPI number | 1124242813 |
|---|---|
| LBN Legal business name | Johnson, Dennis Douglas |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 12th, 2007 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1124242813 | NPPES |
| Oregon | MEDICAID | 14097-0 |
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