Provider Demographics
NPI:1952855512
Name:JOHNSON, HILLARY BRIANNE (DDS)
Entity Type:Individual
Prefix:
First Name:HILLARY
Middle Name:BRIANNE
Last Name:JOHNSON
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:PO BOX 240
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:TX
Mailing Address - Zip Code:77534-0240
Mailing Address - Country:US
Mailing Address - Phone:979-758-1313
Mailing Address - Fax:
Practice Address - Street 1:2095 W MAIN ST
Practice Address - Street 2:
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573-3581
Practice Address - Country:US
Practice Address - Phone:281-332-1919
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-11
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32190122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist