MEDICARE: CHRISTOPHER 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	149	NE
2	1223P0221X	Pediatric Dentistry	149	NE
3	1223P0221X	Pediatric Dentistry	203820	CO

General Provider Information

NPI Number	:	1821508359
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER JOHNSON DDS

Provider Business Mailing Address
First Line	:	6620 CAMDEN BLVD
Second Line	:
City	:	FOUNTAIN
State	:	CO
Zip	:	80817-2505
Country	:	US
Telephone Number	:	719-722-4999
Fax Number	:

Provider Business Practice Location Address
First Line	:	6620 CAMDEN BLVD
Second Line	:
City	:	FOUNTAIN
State	:	CO
Zip	:	80817-2505
Country	:	US
Telephone Number	:	719-631-6136
Fax Number	:	719-931-5556

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

Provider Enumeration Date	:	10/11/2017
Last Update Date	:	07/28/2025

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