Dr. Kirby Charles Johnson
Oral and Maxillofacial Surgeon
3905 Silver Lake Rd
St Anthony
, Minnesota 55421
Dr. Kirby Charles Johnson
Oral and Maxillofacial Surgeon
3905 Silver Lake Rd
St Anthony
, Minnesota 55421
(612) 788-5511
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About
Features
Specialties
- Oral and Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Dr. Kirby Charles Johnson
- 320 Calamus Circle
- Medina, MN
- Zip : 55340
- Fax : (612) 788-5511
- Phone : (612) 788-9246
Second Address
- Dr. Kirby Charles Johnson
- 3905 Silver Lake Rd
- St Anthony, MN
- Zip : 55421
- Fax : (612) 788-5511
- Phone : (612) 788-9246
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223S0112X | Oral and Maxillofacial Surgeon | 10472DDS | MN |
National Provider Identifier
| NPI | 1023045341 |
|---|---|
| Provider Name | Dr. Kirby Charles Johnson |
| First Address | Medina, MN 55340 |
| Second Address | St Anthony, MN 55421 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 26/06/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| T93145 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.