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General NPI Number Information
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NPI Number | 1881429108
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Entity Type | Organization
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Legal Business Name | VERANDA DENTISTRY JOHNSTON, PLC
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Dates
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Enumeration Date | 09/05/2024
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Last Update Date | 09/05/2024
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Provider Practice Location Address
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Address Line | 5721 MERLE HAY RD STE 12
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City | JOHNSTON
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State | IA
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Zip | 50131-1264
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Country | US
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Telephone | 515-278-2379
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Fax |
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Provider Business Mailing Address
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Address Line | 5721 MERLE HAY RD STE 12
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City | JOHNSTON
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State | IA
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Zip | 50131-1264
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Country | US
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Telephone | 515-266-3700
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Fax |
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Authorized Official
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Title or Position | MANAGER, VERANDA DENTISTRY JOHNSTON
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Name | DR. CHADWICK A JOHNSON
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Credential | DDS
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Telephone | 515-278-2379
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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