Provider Demographics
NPI:1659683696
Name:JOHNSON, ERIKA BHATELEY (DDS)
Entity type:Individual
Prefix:DR
First Name:ERIKA
Middle Name:BHATELEY
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3750 COMMERCIAL AVE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78221-3117
Mailing Address - Country:US
Mailing Address - Phone:210-334-3700
Mailing Address - Fax:210-922-0162
Practice Address - Street 1:3750 COMMERCIAL AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78221-3117
Practice Address - Country:US
Practice Address - Phone:210-334-3780
Practice Address - Fax:210-923-4167
Is Sole Proprietor?:No
Enumeration Date:2010-07-07
Last Update Date:2011-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX256011223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice