Provider Demographics
NPI:1124227970
Name:FRANKENBERY & JOHNSON DDS PA
Entity Type:Organization
Organization Name:FRANKENBERY & JOHNSON DDS PA
Other - Org Name:MARTIN AND FRANKENBERY DDS PA
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PRESIDENT/OWNER FRANKENBERY & JOHNS
Authorized Official - Prefix:DR
Authorized Official - First Name:TODD
Authorized Official - Middle Name:A
Authorized Official - Last Name:FRANKENBERY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:316-634-0990
Mailing Address - Street 1:3101 NORTH CYPRESS ST
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67226
Mailing Address - Country:US
Mailing Address - Phone:316-634-0990
Mailing Address - Fax:316-634-1781
Practice Address - Street 1:3101 NORTH CYPRESS ST
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67226
Practice Address - Country:US
Practice Address - Phone:316-634-0990
Practice Address - Fax:316-634-1781
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:FRANKENBERY & JOHNSON DDS PA
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-07-12
Last Update Date:2019-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS69551223G0001X
KS44141223G0001X
KS604811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty