Provider Demographics
NPI:1346268224
Name:JOHNSON & SILVA, DDS, PC
Entity Type:Organization
Organization Name:JOHNSON & SILVA, DDS, PC
Other - Org Name:CHESTERFIELD DENTAL ASSOCIATES, INC.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:E
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:636-532-3208
Mailing Address - Street 1:16100 CHESTERFIELD PKWY W
Mailing Address - Street 2:SUITE 320
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:63017-4871
Mailing Address - Country:US
Mailing Address - Phone:636-532-3208
Mailing Address - Fax:636-532-1371
Practice Address - Street 1:16100 CHESTERFIELD PKWY W
Practice Address - Street 2:SUITE 320
Practice Address - City:CHESTERFIELD
Practice Address - State:MO
Practice Address - Zip Code:63017-4871
Practice Address - Country:US
Practice Address - Phone:636-532-3208
Practice Address - Fax:636-532-1371
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO12610122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty