Johnson, Tessa Jean
Johnson, Tessa Jean is an individual health care provider with primary practice located at 1415 Vermont St , Quincy IL 62301-3119. She recently has only one registered license in Dental Providers / Dentist, which is considered as her primary health care specialty. Johnson, Tessa Jean can be contacted via phone (217) 223-5611.Contact Information
Primary practice address
1415 Vermont St
Quincy IL 62301-3119
Phone: (217) 223-5611
Fax: (217) 223-5650
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | Illinois |
Profile Details
| NPI number | 1487613816 |
|---|---|
| LBN Legal business name | Johnson, Tessa Jean |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 23rd, 2006 |
| Last updated | Jul 8th, 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 | 1487613816 | NPPES |
| Illinois | MEDICAID | 9177134 |
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