Healthcare Provider Details

I. General information

NPI: 1912889288
Provider Name (Legal Business Name): CHRISTOPHER EVAN JOHNSON DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/25/2025
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

650 HUEBNER RD
FORT RILEY KS
66442-4030
US

IV. Provider business mailing address

801 PEBBLEBROOK CIR APT 8
MANHATTAN KS
66503-9696
US

V. Phone/Fax

Practice location:
  • Phone: 785-239-7337
  • Fax: 630-570-5779
Mailing address:
  • Phone: 913-744-0920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2025019345
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: