Brock Jonathan Johnson, DDS
Dentist in Yuma, CO. Individual provider (NPI-1).
NPI number1013049006
StatusActive
Last updated in NPPESAug 15, 2007
Details
- NPI
- 1013049006
- Entity type
- Individual (NPI-1)
- Name
- Brock Jonathan Johnson
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Mar 12, 2007
- Last updated
- Aug 15, 2007
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 9241 | CO | Yes |
Practice location
900 S. Ash St.Yuma, CO 80759
Phone 970-848-5777
Mailing address
615 S Cedar StYuma, CO 80759-2713
Phone 970-848-0960
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