Provider Demographics
NPI:1235125519
Name:JOHNSON, STEVEN C (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:C
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1851 OAK ST
Mailing Address - Street 2:SUITE B.
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-3007
Mailing Address - Country:US
Mailing Address - Phone:661-395-0698
Mailing Address - Fax:661-395-0530
Practice Address - Street 1:1851 OAK ST
Practice Address - Street 2:SUITE B.
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-3007
Practice Address - Country:US
Practice Address - Phone:661-395-0698
Practice Address - Fax:661-395-0530
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA241231223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics