Individual
DANIELLE JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
355 K ST, CHULA VISTA, CA 91911-1209
(619) 934-5713
Mailing address
1741 EASTLAKE PKWY PMB 5043, STE 102, CHULA VISTA, CA 91915-2032
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
12652
TN
1223G0001X
General Practice Dentistry
0401415125
VA
1223G0001X
General Practice Dentistry
Primary
104407
CA
Other
Enumeration date
05/01/2013
Last updated
05/07/2025
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