IndividualActive
Gary Johnson, D.D.S.
NPI 1649294927 · General Practice Dentistry · Berkeley, IL
Provider details
- NPI number
- 1649294927
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- No
- License
- 019017208 (IL)
Specialties & taxonomies
Dental Providers
Dental Providers
Practice location
5646 Saint Charles Rd
Suite C
Berkeley, IL 60163-1148
Phone: (708) 544-7474
Approximate (ZIP-level) locationGet directions
Mailing address
5646 Saint Charles Rd
Berkeley, IL 60163-1148
Registry dates
- Enumerated
- 2006-07-27
- Last updated
- 2015-10-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.