Provider Demographics
NPI:1730184771
Name:PERRY, JOHVIN
Entity type:Individual
Prefix:DR
First Name:JOHVIN
Middle Name:
Last Name:PERRY
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:NAVAL HOSPITAL YOKOSUKA JAPAN
Mailing Address - Street 2:PSC 475 BX1
Mailing Address - City:FPO
Mailing Address - State:AP
Mailing Address - Zip Code:96350-1200
Mailing Address - Country:US
Mailing Address - Phone:315-243-8808
Mailing Address - Fax:
Practice Address - Street 1:U.S. NAVAL HOSPITAL YOKOSUKA
Practice Address - Street 2:PSC 475 BOX 1
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96350-9998
Practice Address - Country:US
Practice Address - Phone:0118146-816-3499
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-16
Last Update Date:2023-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60267320122300000X, 1223P0700X
CA45603122300000X, 1223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics
No122300000XDental ProvidersDentist