Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nicholas Ryan Johnston

Individual provider Dentist · NPI 1093565442

Nicholas Ryan Johnston is a Dentist in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2024.

Licensed in
PA
In the registry since
2024
Specialties on file
2
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Practice location Address checks out

3400 Civic Center Blvd
Philadelphia, PA 19104-5127
Phone: (925) 640-4205
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X · Licence DS044765 (PA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1093565442
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedMarch 26, 2024
Last updated in NPPESDecember 2, 2025
Certification dateDecember 2, 2025

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