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
Phone: (317) 773-1302
Fax: (317) 773-4214
Website:
Health care specialties
| Specialty | Code | License # | 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 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1457481582 | NPPES |
| Indiana | MEDICAID | 35-1982894 |
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