Johnston, Derrick A

Johnston, Derrick A is an sole proprietor health care provider with primary practice located at 455 Sheridan Rd , Noblesville IN 46060-1315. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Johnston, Derrick A can be contacted via phone (317) 773-1302.

Contact Information

Primary practice address
455 Sheridan Rd Noblesville IN 46060-1315
Fax: (317) 773-4214
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 12209722 Indiana
Dental Providers / General Practice 1223G0001X 12009722 Indiana

Profile Details

NPI number 1457481582
LBN Legal business name Johnston, Derrick A
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 7th, 2007
Last updated Apr 17th, 2018 - about 7 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 1457481582 NPPES
Indiana MEDICAID 35-1982894

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