Gregory Lee Johnson in Fairbanks - Pediatric Dentistry
Gregory Lee Johnson - NPI 1376571521
Gregory Lee Johnson is a Pediatric Dentistry in Fairbanks, Alaska. Gregory Lee Johnson practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Gregory Lee Johnson is 1376571521. The last update date is 2022-02-05.
Gregory Lee Johnson's current location address is 114 Minnie St, Fairbanks, Alaska. You can contact this provider via phone number 9073883252. The mailing address for Gregory Lee Johnson is 114 Minnie St, Fairbanks, Alaska. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Gregory Lee Johnson |
|---|---|
| Address | 114 Minnie St, Fairbanks, Alaska |
| Phone Number | 9073883252 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | D.D.S |
NPI Number Detail
| NPI Number | 1376571521 |
|---|---|
| Provider Enumeration Date | 2006-06-28 |
| Last Updated Date | 2022-02-05 |
Provider Mailing Address Detail
| Address | 114 Minnie St |
|---|---|
| City | Fairbanks |
| State | Alaska (AK) |
| Post Code | 997013006 |
| Phone Number | 9073883252 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | 657 |
|
Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| DD0657 | AK | -- |
Post Comment/ Review Below
What is the unique provider identifier assigned to Gregory Lee Johnson?
The Gregory Lee Johnson has been issued the NPI (National Provider Identifier) 1376571521 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.
Could you provide the complete address where Gregory Lee Johnson is physically located?
The Gregory Lee Johnson is situated at the following address: 114 Minnie St, Fairbanks, AK 997013006.
What is the Gregory Lee Johnson's specialty and taxonomy code?
The Gregory Lee Johnson's specialty is Pediatric Dentistry, and the corresponding taxonomy code is 1223P0221X.
On what date did the Centers for Medicare & Medicaid Services assign the 1376571521 to Gregory Lee Johnson?
The Centers for Medicare & Medicaid Services assigned the 1376571521 to Gregory Lee Johnson on 2006-06-28.
As of what date was the information pertaining to Gregory Lee Johnson, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Gregory Lee Johnson, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2022-02-05.
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