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NPI Code Detail

MEDICARE: DR. JOYCE MARIE JOHNSON D.D.S.

MEDICARE: DR. JOYCE MARIE JOHNSON D.D.S.
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
11223G0001XGeneral Practice Dentistry22D101726900NJ

General Provider Information

NPI Number : 1265557276
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOYCE MARIE JOHNSON D.D.S.
Provider Business Mailing Address
First Line : 34 JENNIFER PL
Second Line :
City : GLEN ROCK
State : NJ
Zip : 07452-2708
Country : US
Telephone Number : 201-652-8089
Fax Number : 201-652-0906
Provider Business Practice Location Address
First Line : 88 W RIDGEWOOD AVE
Second Line :
City : RIDGEWOOD
State : NJ
Zip : 07450-3199
Country : US
Telephone Number : 201-652-8875
Fax Number : 201-652-3333
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/20/2007
Last Update Date : 07/08/2007

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