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General NPI Number Information
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NPI Number | 1295229722
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Entity Type | Individual
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Provider Name | DANIEL DARIUS JOHNSON DDS
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Gender | Male
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Dates
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Enumeration Date | 06/18/2018
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Last Update Date | 06/18/2018
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Provider Practice Location Address
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Address Line | 6109 E HIGHWAY 191
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City | ODESSA
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State | TX
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Zip | 79762-5348
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Country | US
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Telephone | 432-305-0049
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Fax |
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Provider Business Mailing Address
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Address Line | 7707 VALERA LN
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City | HOUSTON
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State | TX
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Zip | 77083-5138
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Country | US
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Telephone | 832-483-5762
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 34018
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License Number State | TX
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