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Contact Information

BRYAN D. JOHNSON, DDS, PA
516 MAIN STREET
MADISON LAKE, MN56063
 Phone: 507-243-3747
 Fax: 507-243-3866
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for BRYAN D. JOHNSON, DDS, PA

NPI # 1043208267
LBN Legal business name BRYAN D. JOHNSON, DDS, PA
Authorized official BRYAN JOHNSON - (DENTIST)
Entity Organization
Organization subpart 1 No
Enumeration date 10/11/2005
Last updated 08/22/2020 - About 6 years ago
Identifiers
MN License # D9815
MN Other 41321JO BLUE CROSS BLUE SHIELD
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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