Johnson, Jeffrey W

Johnson, Jeffrey W is an sole proprietor health care provider with primary practice located at 333 S Woodruff Ave , Idaho Falls ID 83401-4322. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Johnson, Jeffrey W can be contacted via phone (208) 529-3500.

Contact Information

Primary practice address

333 S Woodruff Ave Idaho Falls ID 83401-4322

Phone: (208) 529-3500

Fax: (208) 523-9004

Website:

Map and Directions

Health care specialties

Specialty	Code	License #	State
Dental Providers / Orthodontics and Dentofacial Orthopedics	1223X0400X	D3190OR	Idaho
Dental Providers / Orthodontics and Dentofacial Orthopedics	1223X0400X	8041458	Utah

Profile Details

NPI number	1821130253
LBN Legal business name	Johnson, Jeffrey W
Credentials	DDS, MS
Entity	Individual
Sole proprietor ¹	Yes
Enumeration date	Feb 13th, 2007
Last updated	Jul 20th, 2011 - about 14 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

State	Type	Number	Issuer
All States	NPI	1821130253	NPPES
Idaho	MEDICAID	805176600

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