Organization
JJS OPTICAL LLC
Active
Other names
Dinkytown Optical
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES EDWARD JOHNSON (PRESIDENT)
(651) 227-6506
Entity
Organization
Contact information
Practice address
1304 4TH ST SE, MINNEAPOLIS, MN 55414-2029
(612) 331-7100
(612) 331-7100
Mailing address
101 5TH ST E STE 281, SAINT PAUL, MN 55101-1862
(651) 227-6506
(651) 288-4740
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
MN1582
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
126892
HEALTH PARTNERS
—
05
—
165105600
—
MN
01
—
165577
UCARE MINNESOTA
—
01
—
2115817
MEDICA
—
01
—
354K1ME
BLUE CROSS BLUE SHIELD (EXAMS)
—
01
—
972N3ME
BLUE CROSS BLUE SHIELD (MATERIALS)
—
Enumeration date
02/11/2009
Last updated
02/11/2009
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