Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. KENNETH JOHANNESEN, DDS
ActiveDR. KENNETH JOHANNESEN, DDS is a Dentist healthcare provider located in NORTHPORT, New York. NPI 1477507754 is currently active in the NPPES registry. Verify at CMS.
Dentist · NORTHPORT, NY
Registration Details
- NPI Number
- 1477507754
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- May 20, 2006 (20.245458451388 yrs)
- Last Updated
- Jul 12, 2007
- License
-
044235 (NY)
Practice Information
- Address
-
79 MIDDLEVILLE RDDVAMC NORTHPORT (160)NORTHPORT, NY, 117682200Browse NY providers · Browse ZIP 11768
- Phone
- 6312666057
- Fax
- 6312666020
- Primary Specialty
-
Dentist
122300000X
Other Dentist Providers in NORTHPORT, NY
| Name | Credential | NPI |
|---|---|---|
| DR. JOHN EVERETT CANCROFT | D.D.S. | 1306969316 |
| DR. TIFFANY ABRISHAMIAN | — | 1053731893 |
| DR. SAMAN HASAN | D.D.S. | 1326468539 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.