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General NPI Number Information
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NPI Number | 1063253672
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Entity Type | Organization
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Legal Business Name | BENJAMIN JOHNSON DDS, PLLC.
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Dates
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Enumeration Date | 06/06/2024
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 275 SW 160TH ST STE 115
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City | BURIEN
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State | WA
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Zip | 98166-3003
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Country | US
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Telephone | 425-277-1844
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Fax |
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Provider Business Mailing Address
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Address Line | 601 S CARR RD STE 300
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City | RENTON
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State | WA
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Zip | 98055-5840
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. BENJAMIN JOHNSON
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Credential | DMD
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Telephone | 425-277-1844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number |
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License Number State |
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