Provider Demographics
NPI:1033445374
Name:MERLE W. JOHNSON, D.D.S., INC.
Entity Type:Organization
Organization Name:MERLE W. JOHNSON, D.D.S., INC.
Other - Org Name:JOHNSON DENTISTRY
Other - Org Type:Other Name
Authorized Official - Title/Position:TREASURER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:BENNION
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:760-244-2027
Mailing Address - Street 1:9176 I AVE
Mailing Address - Street 2:
Mailing Address - City:HESPERIA
Mailing Address - State:CA
Mailing Address - Zip Code:92345-6526
Mailing Address - Country:US
Mailing Address - Phone:760-244-2027
Mailing Address - Fax:760-244-0361
Practice Address - Street 1:9176 I AVE
Practice Address - Street 2:
Practice Address - City:HESPERIA
Practice Address - State:CA
Practice Address - Zip Code:92345-6526
Practice Address - Country:US
Practice Address - Phone:760-244-2027
Practice Address - Fax:760-244-0361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-21
Last Update Date:2009-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty