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Contact Information

KENNETH W JOHNSON, DDS
704 HILLCREST
TUPELO, MS38804
 Phone: 662-840-8540
 Fax: 662-840-0629
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatric Dentistry

1223P0221X
Indicates primary specialty

NPI Profile & details for KENNETH W JOHNSON · (Male)

NPI # 1497836704
Status Active
Credentials DDS (Doctor of Dental Surgery)
Entity Individual
Enumeration date 10/17/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • MS License # PEDO29796
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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