# THE DENTISTS CLINIC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** ISA Dental
- **Organization subpart:** No

## Provider details

- **NPI number:** 1093909558
- **Authorized official:** DR. JEFFREY CHARLES JOHNSON DDS (GENERAL PARTNER)
- **Authorized official phone:** (671) 646-7982

## Contact information

- **Practice address:** 761 S MARINE CORPS DRIVE, SUITE A-2 CENTAM BUILDING, TAMUNING, GU 96913
- **Practice address phone:** (671) 646-7982
- **Practice address fax:** (671) 646-7989
- **Mailing address:** PO BOX W, HAGATNA, GU 96932
- **Mailing address phone:** (671) 646-7982
- **Mailing address fax:** (671) 646-7989

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | D 829 | GU | Yes |
| 1223P0221X | Pediatric Dentistry | D 901 | GU | — |

## Other

- **Enumeration date:** 08/28/2007
- **Last updated:** 08/28/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 185 | — | GU |
| 01 | — | 555029 | HAWAII DENTAL SERVICES | HI |