Provider Demographics
NPI:1598892358
Name:JOHNSON, STEVEN GARY (DDS)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:GARY
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 1:3906 STATE ST
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93105-3114
Mailing Address - Country:US
Mailing Address - Phone:805-687-6767
Mailing Address - Fax:805-682-8713
Practice Address - Street 1:3906 STATE ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93105-3114
Practice Address - Country:US
Practice Address - Phone:805-687-6767
Practice Address - Fax:805-682-8713
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA421631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice