MEDICARE: DR. W. KAHLE JOHNSON JR. 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
1	1223G0001X	General Practice Dentistry	DSO26087	PA

General Provider Information

NPI Number	:	1811103963
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. W. KAHLE JOHNSON JR. D.D.S.

Provider Business Mailing Address
First Line	:	360 FREEPORT ST
Second Line	:
City	:	NEW KENSINGTON
State	:	PA
Zip	:	15068-6015
Country	:	US
Telephone Number	:	724-335-8876
Fax Number	:

Provider Business Practice Location Address
First Line	:	360 FREEPORT ST
Second Line	:
City	:	NEW KENSINGTON
State	:	PA
Zip	:	15068-6015
Country	:	US
Telephone Number	:	724-335-8876
Fax Number	:

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

Provider Enumeration Date	:	05/15/2007
Last Update Date	:	03/07/2023

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Directions to “ DR. W. KAHLE JOHNSON JR. D.D.S.” Practice Location

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