Bryan D. Johnson, DDS, PA

General Practice Dentistry · Madison Lake, MN

Organization Active NPI

NPI number 1043208267

Practice location

516 Main Street
Madison Lake, MN 56063

Phone: (507) 243-3747
Fax: (507) 243-3866

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NPI record

NPI: 1043208267
Entity type: Organization (Type 2)
Enumeration date: October 11, 2005
Last updated: August 22, 2020
Organization subpart: No

Specialties & taxonomy codes

Taxonomy	Code	License	State
General Practice Dentistry Primary	`1223G0001X`	D9815	MN

Mailing address

PO Box 458
Madison Lake, MN 56063-0458

Phone: (507) 243-3747
Fax: (507) 243-3866

Authorized official

Name: Dr. Bryan D. Johnson, DDS
Title: Dentist
Phone: (507) 243-3747

About Bryan D. Johnson, DDS, PA

Bryan D. Johnson, DDS, PA is a healthcare organization registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 516 Main Street, Madison Lake, MN 56063. The NPI number 1043208267 was assigned on October 11, 2005 and the record was last updated on August 22, 2020.

Bryan D. Johnson, DDS, PA lists a license in the registry: #D9815 (MN) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

The authorized official for this organization is Dr. Bryan D. Johnson, DDS, Dentist.

Frequently asked questions

What is the NPI number of Bryan D. Johnson, DDS, PA?

The NPI number is 1043208267.

What is the phone number of Bryan D. Johnson, DDS, PA?

The phone number listed for the practice location is (507) 243-3747.

Where is Bryan D. Johnson, DDS, PA located?

516 Main Street, Madison Lake, MN 56063.

What is the taxonomy code for Bryan D. Johnson, DDS, PA?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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