Provider Demographics
NPI:1104987528
Name:JOHL, TEJPAUL (DDS)
Entity type:Individual
Prefix:DR
First Name:TEJPAUL
Middle Name:
Last Name:JOHL
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 1:1318 IMPERIA DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-4053
Mailing Address - Country:US
Mailing Address - Phone:415-307-4467
Mailing Address - Fax:702-629-3962
Practice Address - Street 1:1318 IMPERIA DR
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-4053
Practice Address - Country:US
Practice Address - Phone:415-307-4467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2011-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA454721223E0200X
AZ74671223E0200X
NVS7-451223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics