# JESSICA M JOHNSON DDS PA

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Ottawa Kansas Dentistry
- **Organization subpart:** No

## Provider details

- **NPI number:** 1225559818
- **Authorized official:** DR. JESSICA MARIE JOHNSON DDS (PRESIDENT)
- **Authorized official phone:** (785) 766-1031

## Contact information

- **Practice address:** 1334 S MAIN ST, OTTAWA, KS 66067-3527
- **Practice address phone:** (785) 242-5753
- **Mailing address:** 1334 S MAIN ST, OTTAWA, KS 66067-3527
- **Mailing address phone:** (785) 242-5753

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 61001 | KS | Yes |

## Other

- **Enumeration date:** 07/04/2017
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 61001 | LICENSE NUMBER | KS |