Johnson, Jeremy Robert

Johnson, Jeremy Robert is an individual health care provider with primary practice located at 1006 A St , Greeley CO 80631-2021. He recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Dentist. Dental Providers / Dentist is his primary health care specialty. Johnson, Jeremy Robert can be contacted via phone (970) 352-0048.

Contact Information

Primary practice address
1006 A St Greeley CO 80631-2021
Phone: (970) 352-0048
Fax: (970) 352-1120
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X DO816 South Dakota
Dental Providers / Dentist 122300000X 202438 Colorado

Profile Details

NPI number 1801058599
LBN Legal business name Johnson, Jeremy Robert
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 25th, 2008
Last updated Aug 10th, 2015 - about 9 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 1801058599 NPPES
Colorado MEDICAID 99074559

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