Provider Demographics
NPI:1063553659
Name:JOHNSON, DENNIS CRAIG (DDS)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:CRAIG
Last Name:JOHNSON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 W GARTNER RD
Mailing Address - Street 2:SUITE 124
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60540-7521
Mailing Address - Country:US
Mailing Address - Phone:630-369-8000
Mailing Address - Fax:630-369-9706
Practice Address - Street 1:8 W GARTNER RD
Practice Address - Street 2:SUITE 124
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60540-7521
Practice Address - Country:US
Practice Address - Phone:630-369-8000
Practice Address - Fax:630-369-9706
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice