Provider Demographics
NPI:1124757976
Name:JOHNSON, PARKER HINDLEY (DDS)
Entity type:Individual
Prefix:DR
First Name:PARKER
Middle Name:HINDLEY
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 1:933 N 2220 W
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:UT
Mailing Address - Zip Code:84015-9576
Mailing Address - Country:US
Mailing Address - Phone:435-740-0154
Mailing Address - Fax:
Practice Address - Street 1:668 N GARDEN ST
Practice Address - Street 2:
Practice Address - City:TOOELE
Practice Address - State:UT
Practice Address - Zip Code:84074-1724
Practice Address - Country:US
Practice Address - Phone:435-882-1381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-07
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIDT-3004-0122300000X
UT14018806-9926122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist