Individual
DR. GREGORY P JOHNSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
5394 WALNUT AVE, SUITE H, IRVINE, CA 92604-2505
(949) 552-5800
(949) 552-8905
Mailing address
5394 WALNUT AVE, SUITE H, IRVINE, CA 92604-2505
(949) 552-5800
(949) 552-8905
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
D22813
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1790054344
DENTICAL
CA
01
—
B22813
DENTICAL
CA
01
—
CGP097860
CALIFORNIA CHILDREN'S SERVICES
CA
01
—
CGP171091
CALIFORNIA CHILDREN'S SERVICES
CA
Enumeration date
03/21/2007
Last updated
12/30/2011
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