Individual
DR. JAMIE L. JOHNSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1001 S PUEBLO BLVD, PUEBLO, CO 81005-1682
(719) 564-0990
(719) 564-6817
Mailing address
1001 S PUEBLO BLVD, PUEBLO, CO 81005-1505
(719) 564-0990
(719) 564-6817
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7380
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02073807
—
CO
Enumeration date
07/13/2005
Last updated
02/15/2026
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