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NPI Code Detail

MEDICARE: DAVID DELOSS JOHNSON DDS

MEDICARE: DAVID DELOSS 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
1122300000XDentistD15441MN

General Provider Information

NPI Number : 1518897487
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID DELOSS JOHNSON DDS
Provider Business Mailing Address
First Line : 1905 PLAZA DR
Second Line :
City : EAGAN
State : MN
Zip : 55122-2883
Country : US
Telephone Number : 651-686-6800
Fax Number :
Provider Business Practice Location Address
First Line : 1905 PLAZA DR
Second Line :
City : EAGAN
State : MN
Zip : 55122-2883
Country : US
Telephone Number : 651-686-6800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/21/2026
Last Update Date : 05/21/2026

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Directions to “ DAVID DELOSS JOHNSON DDS” Practice Location

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