Provider Demographics
NPI:1245525187
Name:ACHURY-PEARSON, JOHANNA (JOHANNA ACHURY DDS)
Entity type:Individual
Prefix:
First Name:JOHANNA
Middle Name:
Last Name:ACHURY-PEARSON
Suffix:
Gender:F
Credentials:JOHANNA ACHURY DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4101 DUBLIN BLVD STE F-64
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:CA
Mailing Address - Zip Code:94568-4592
Mailing Address - Country:US
Mailing Address - Phone:415-347-8995
Mailing Address - Fax:415-347-8996
Practice Address - Street 1:2001 UNION ST
Practice Address - Street 2:SUITE 664
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94123-4114
Practice Address - Country:US
Practice Address - Phone:415-347-8995
Practice Address - Fax:415-347-8996
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-17
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA501981223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice