Healthcare Provider Details

I. General information

NPI: 1043104011
Provider Name (Legal Business Name): VI DINH JOHNSON DDS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2025
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1640 CHARLES PL STE 101
MANHATTAN KS
66502-2868
US

IV. Provider business mailing address

1640 CHARLES PL STE 101
MANHATTAN KS
66502-2868
US

V. Phone/Fax

Practice location:
  • Phone: 785-537-8484
  • Fax: 785-537-2281
Mailing address:
  • Phone: 785-537-8484
  • Fax: 785-537-2281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number62321
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: