Provider Demographics
NPI:1043449515
Name:JOHNSON, ELIZABETH ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANN
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:LIBBY
Other - Middle Name:
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DDS
Mailing Address - Street 1:3272 SALT CREEK CIR
Mailing Address - Street 2:SUITE A
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68504-4759
Mailing Address - Country:US
Mailing Address - Phone:402-476-1500
Mailing Address - Fax:
Practice Address - Street 1:3272 SALT CREEK CIR
Practice Address - Street 2:SUITE A
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68504-4759
Practice Address - Country:US
Practice Address - Phone:402-476-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-06
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE68381223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry