Provider Demographics
NPI:1558703421
Name:JOHNSTONE, LINDA (DDS)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:
Last Name:JOHNSTONE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1868 E THOUSAND OAKS BLVD
Mailing Address - Street 2:SUITE #100
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91362-2953
Mailing Address - Country:US
Mailing Address - Phone:805-796-6983
Mailing Address - Fax:
Practice Address - Street 1:1868 E THOUSAND OAKS BLVD
Practice Address - Street 2:SUITE #100
Practice Address - City:THOUSAND OAKS
Practice Address - State:CA
Practice Address - Zip Code:91362-2953
Practice Address - Country:US
Practice Address - Phone:805-796-6983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-22
Last Update Date:2013-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA45456122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist