# JOHNSON, DIXSON & POND DENTISTRY

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

## Provider details

- **NPI number:** 1912026063
- **Authorized official:** DR. JEROMY R. DIXSON DMD (PARTNER)
- **Authorized official phone:** (360) 577-0566

## Contact information

- **Practice address:** 820 OCEAN BEACH HWY,, STE 110, LONGVIEW, WA 98632-4011
- **Practice address phone:** (360) 577-0566
- **Practice address fax:** (360) 425-6935
- **Mailing address:** 820 OCEAN BEACH HWY, STE 110, LONGVIEW, WA 98632-4080
- **Mailing address phone:** (360) 577-0566
- **Mailing address fax:** (360) 425-6935

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DE00008175 | WA | — |
| 1223G0001X | General Practice Dentistry | DE00009942 | WA | Yes |

## Other

- **Enumeration date:** 03/28/2007
- **Last updated:** 03/18/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1205926110 | NPI- PERSONAL | WA |
| 05 | — | 5046164 | — | WA |