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NPI Code Detail

MEDICARE: ANDREW PAULLIN JOHNSON D.M.D.

MEDICARE: ANDREW PAULLIN JOHNSON D.M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistDE00010277WA

General Provider Information

NPI Number : 1053479279
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW PAULLIN JOHNSON D.M.D.
Provider Business Mailing Address
First Line : 605 S COOLIDGE ST
Second Line :
City : MOSES LAKE
State : WA
Zip : 98837-1873
Country : US
Telephone Number : 509-679-5352
Fax Number :
Provider Business Practice Location Address
First Line : 605 S COOLIDGE ST
Second Line :
City : MOSES LAKE
State : WA
Zip : 98837-1873
Country : US
Telephone Number : 509-765-0674
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/04/2006
Last Update Date : 01/23/2026

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