Johnson, Jamie L.

Johnson, Jamie L. is an individual health care provider with primary practice located at 1001 S Pueblo Blvd , Pueblo CO 81005-1682. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Johnson, Jamie L. can be contacted via phone (719) 564-0990.

Contact Information

Primary practice address
1001 S Pueblo Blvd Pueblo CO 81005-1682
Phone: (719) 564-0990
Fax: (719) 564-6817
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 7380 Colorado

Profile Details

NPI number 1114925955
LBN Legal business name Johnson, Jamie L.
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 13th, 2005
Last updated Jul 9th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1114925955 NPPES
Colorado MEDICAID 02073807

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