MEDICARE: MR. NICHOLAS CRAIG JOHNSON DDS

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
1	122300000X	Dentist		IL

General Provider Information

NPI Number	:	1184738346
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. NICHOLAS CRAIG JOHNSON DDS

Provider Business Mailing Address
First Line	:	5753 ITASKA ST
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63109-2835
Country	:	US
Telephone Number	:	314-766-2724
Fax Number	:

Provider Business Practice Location Address
First Line	:	50 N CENTER ST
Second Line	:
City	:	EAST ALTON
State	:	IL
Zip	:	62024-1708
Country	:	US
Telephone Number	:	618-259-5563
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/17/2006
Last Update Date	:	08/10/2007

Similar Medicare Providers

1407796014 — INDEED HOME CARE LLC
Practice Location Address:

505 RUNNYMEDE ST STE 7
EAST PALO ALTO, CA
94303-1708

Practice Phone: 650-720-1204
Practice Fax:

1750367454 — MS. LISA ROBINSON R.N., ARNP
Practice Location Address:

1708 EAST 44TH STREET , COMMUNITY HEALTH CARE
TACOMA, WA
98404

Practice Phone: 253-471-4553
Practice Fax: 253-474-5395

1285692756 — DR. BEVERLY BIANES PACK OD
Practice Location Address:

374 EAST H ST , STE 1708
CHULA VISTA, CA
91910-7484

Practice Phone: 619-425-7990
Practice Fax: 619-425-7992

1699726463 — REBECCA ANN KRAMER CRNA
Practice Location Address:

1708 EAST 23RD STREET
HUTCHINSON, KS
67502

Practice Phone: 620-663-7187
Practice Fax:

1417061508 — KEVIN DANIEL VERRRETT DDS
Practice Location Address:

1708 EAST PASS ROAD
GULFPORT, MS
39507

Practice Phone: 228-822-9190
Practice Fax: 228-822-9559

1598855926 — MEDICATE PHARMACY SHOPPES INC
Practice Location Address:

7602 STATE ST
EAST SAINT LOUIS, IL
62203-1708

Practice Phone: 618-397-3331
Practice Fax: 618-397-6050

Directions to “ MR. NICHOLAS CRAIG JOHNSON DDS” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.