Stephen Ackerman Johnson, D.D.S.
Individual provider Active NPI General Practice Dentistry · Monmouth, IL
NPI 1194941849 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1194941849
- Entity type
- Individual (NPI type 1)
- Primary specialty
- General Practice Dentistry 1223G0001X
- Practice address
- 225 S 1St St
Monmouth, IL 61462-2201 - Phone
- (309) 734-8403
- Fax
- (309) 734-6870
- NPI assigned
- Apr 18, 2007
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 019015496 | IL | MD | General Practice Dentistry |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | IL | Yes |
Addresses
Primary practice location
225 S 1St St
Monmouth, IL 61462-2201
Mailing address
1339 E Broadway
Monmouth, IL 61462-1980
Phone (309) 734-6368
Other providers in Monmouth, IL
- Payton Holmes
- Byung Il Hyun
- Illinois Medicaid-Substance Abuse Monmouth
- Illinois Primary Urgent Care LLC
- Jamieson Community Center
- Taylor Kate Johnson
- Victoria Kalivoda -Popela
- Debra Katchen
- John K Knapek
- Grace Iyabo Komolafe
All providers in Monmouth, IL · General Practice Dentistry in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.