Provider Demographics
NPI:1861100794
Name:JOHNSON DDS & KESHAV DDS, INC
Entity type:Organization
Organization Name:JOHNSON DDS & KESHAV DDS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANKIT
Authorized Official - Middle Name:
Authorized Official - Last Name:KESHAV
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:949-561-1833
Mailing Address - Street 1:17875 VON KARMAN AVE STE 440
Mailing Address - Street 2:
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92614-6273
Mailing Address - Country:US
Mailing Address - Phone:949-561-1833
Mailing Address - Fax:949-561-1737
Practice Address - Street 1:17875 VON KARMAN AVE STE 440
Practice Address - Street 2:
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92614-6273
Practice Address - Country:US
Practice Address - Phone:949-561-1833
Practice Address - Fax:949-561-1737
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-09
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty