NPI age
19 years
Enumerated 2007-01-23
● Active Type 2 · Organization
Kevin B. Johnson, DDS
Kevin B. Johnson, DDS is 1 of 591 dentist organizations in Idaho.
Primary specialty
Dentist
Practice locations
1
0 secondary on file
Status
Active
No deactivations on record
Authorized official
Johnson
Dentist Owner
Last NPPES update
2008-06-25
Source: monthly bulk 2026-05
How this organization compares
Across 591 active dentist providers in Idaho.
NPI age
19 years
↑ 3 yr above median
Practice locations
1
0 secondary on file
Subspecialties
0
NPI lifetime · 2007 → 2026
2007-01Enumerated in NPPES
2007
2026
Where they practice
Primary practice location
1310 Ponderosa Drive
Sandpoint, ID 83864
Mailing address
1310 Ponderosa Dr Ste A
Sandpoint, ID 838645073
Authorized official
Kevin Bradley Johnson, DDS
Dentist Owner
📞 2082637641
Specialties
-
Dentist PrimaryA dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two...
Identifiers
| Type | Value | Notes |
|---|---|---|
| 05 (ID) | 804280700 |
Practice context
Single-site organization. Only one practice location on file.
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- Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
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- Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.