Johannesen, Kenneth

Johannesen, Kenneth is an individual health care provider with primary practice located at 79 Middleville Rd Dvamc Northport (160), Northport NY 11768-2200. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Johannesen, Kenneth can be contacted via phone (631) 266-6057.

Contact Information

Primary practice address
79 Middleville Rd Dvamc Northport (160) Northport NY 11768-2200
Phone: (631) 266-6057
Fax: (631) 266-6020
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 044235 New York

Profile Details

NPI number 1477507754
LBN Legal business name Johannesen, Kenneth
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2006
Last updated Jul 12th, 2007 - about 19 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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