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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

DR. TYLER RUSSELL JOHANSEN, DMD, MS

Active Sole Proprietor

DR. TYLER RUSSELL JOHANSEN, DMD, MS is a Periodontology healthcare provider located in PEARL HARBOR, Hawaii. NPI 1568718146 is currently active in the NPPES registry. Verify at CMS.

Periodontology · PEARL HARBOR, HI

Registration Details

NPI Number
1568718146
Provider Type
Individual
Gender
Male
NPI Issued
Aug 1, 2012 (14.008118904284 yrs)
Last Updated
May 21, 2025
Licenses
DS039183 (PA)
DS039183 (PA)
Sole Proprietor
Yes

Practice Information

Address
NAVAL HEALTH CLINIC HAWAII
480 CENTRAL AVENUE
PEARL HARBOR, HI, 96860
Browse HI providers · Browse ZIP 96860
Phone
5302763389
Primary Specialty
Periodontology
1223P0300X
Additional Specialty
Periodontology

Other Periodontology Providers in PEARL HARBOR, HI

Name Credential NPI
DR. HEATHER LYNN STEIN DMD, MS 1114902939
DR. MICHAEL KEENE YANG D.D.S. 1215369467
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.