National Provider Identifier

S Michael Johnson, D.D.S.

S Michael Johnson, D.D.S. is listed in the NPPES registry with a primary specialty of General Practice Dentistry in Lakewood, NY and a listed phone number of (716) 763-6823.

NPI 1962622944Lakewood, NYGeneral Practice Dentistry

Profile Overview

NPI
1962622944
Provider Type
Individual
Primary Specialty
General Practice Dentistry
Enumeration Date
May 01, 2007
Last Updated
July 09, 2020

Practice Location

  • 133 E Fairmount Ave
  • Lakewood, NY 14750-1950

Phone: (716) 763-6823

Specialties

  • General Practice Dentistry (1223G0001X)
Full Record
NPI
1962622944
Entity Type
Individual
Last Name
Johnson
First Name
S
Middle Name
Michael
Name Prefix
Dr.
Credential
D.D.S.
Mailing Street Address
133 E Fairmount Ave
Mailing City
Lakewood
Mailing State
NY
Mailing ZIP Code
14750-1950
Mailing Country
US
Mailing Phone
(716) 763-6823
Practice Street Address
133 E Fairmount Ave
Practice City
Lakewood
Practice State
NY
Practice ZIP Code
14750-1950
Practice Country
US
Practice Phone
(716) 763-6823
Enumeration Date
May 01, 2007
Last Updated
July 09, 2020
Sex
Male
Sole Proprietor
Yes
Certification Date
July 09, 2020
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
General Practice Dentistry (1223G0001X)