Provider Demographics
NPI:1548238082
Name:JOHNSTON, TIMOTHY K
Entity Type:Individual
Prefix:DR
First Name:TIMOTHY
Middle Name:K
Last Name:JOHNSTON
Suffix:
Gender:M
Credentials:
Other - Prefix:DR
Other - First Name:TIMOTHY
Other - Middle Name:K
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:7450 RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-7223
Mailing Address - Country:US
Mailing Address - Phone:757-564-0804
Mailing Address - Fax:757-564-0819
Practice Address - Street 1:7450 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-7223
Practice Address - Country:US
Practice Address - Phone:757-564-0804
Practice Address - Fax:757-564-0819
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice