Dr Cory Johnson, DDS is a
Dentist based in South Salt Lake, Utah. Dr Cory Johnson is licensed to practice in Utah (license number 11774185-9922) and his current practice location is
170 E Commonwealth Ave, South Salt Lake, Utah. He can be reached at his office (for appointments etc.) via phone at
(719) 660-8188.
NPI number for Dr Cory Johnson is 1902420318 and his current mailing address is 170 E Commonwealth Ave, South Salt Lake, Utah. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1902420318.
Healthcare Provider's Profile
Full Name | Dr Cory Johnson |
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Gender | Male |
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Speciality | Dentist |
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Location | 170 E Commonwealth Ave, South Salt Lake, Utah |
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Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
NPI Data:
- NPI Number: 1902420318
- Provider Enumeration Date: 06/01/2020
- Last Update Date: 07/24/2020
Medical Identifiers
Medical identifiers for Dr Cory Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1902420318 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
122300000X | Dentist | 11774185-0702 (Utah) | Secondary |
122300000X | Dentist | 11774185-9922 (Utah) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Cory Johnson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Cory Johnson, DDS 170 E Commonwealth Ave, South Salt Lake, UT 84115-2712 Ph: () - | Dr Cory Johnson, DDS 170 E Commonwealth Ave, South Salt Lake, UT 84115-2712 Ph: (719) 660-8188 |
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