Johnson, Charles Keith

Johnson, Charles Keith is an sole proprietor health care provider with primary practice located at 1405 Westover Hills Blvd #1, Richmond VA 23225. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Johnson, Charles Keith can be contacted via phone (804) 232-1533.

Contact Information

Primary practice address
1405 Westover Hills Blvd #1 Richmond VA 23225
Phone: (804) 232-1533
Fax: (804) 232-1560
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 5082 Virginia

Profile Details

NPI number 1013950492
LBN Legal business name Johnson, Charles Keith
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 14th, 2006
Last updated Jul 24th, 2012 - about 14 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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Identifiers

StateTypeNumberIssuer
All States NPI 1013950492 NPPES
Virginia Other 103763 ANTHEM
Virginia MEDICAID 541035205 ANTHEM
Virginia Other 805392 ANTHEM

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