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Contact Information

KISSENDRAH S JOHNSON
01 SAGEBRUSH STREET
ISLETA, NM87022
 Phone: 505-869-4866
 Fax: 502-869-4881
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
Indicates primary specialty

NPI Profile & details for KISSENDRAH S JOHNSON · (Female)

NPI # 1124502984
Status Active
Credentials
Entity Individual
Enumeration date 09/18/2018
Last updated 09/18/2018 - About 8 years ago
Sole proprietor 1 No
Identifiers
  • NM License # DD4977
  • NM Other DD4977 LICENSE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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