Healthcare Provider Details

I. General information

NPI: 1629808480
Provider Name (Legal Business Name): CAMERON MICHAEL JOHNS DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/06/2024
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

UNIT 28753 BOX 6544
APO AE
09250-8753
US

IV. Provider business mailing address

UNIT 28753 BOX 6544
APO AE
09250-8753
US

V. Phone/Fax

Practice location:
  • Phone: 314-590-3700
  • Fax:
Mailing address:
  • Phone: 314-590-3700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number2901602342
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: