DR. Tyler Russell Johansen, DMD, MS

NPI #1568718146 in Pearl Harbor, Hawaii

Provider Information

NPI Number: 1568718146
Entity Type: Individual
Name: DR. Tyler Russell Johansen, DMD, MS
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist - Periodontics
Credential: DMD, MS
Enumeration Date: Aug 1, 2012
Last Updated: May 21, 2025

Practice Location

Address: NAVAL HEALTH CLINIC HAWAII
Address 2: 480 CENTRAL AVENUE
City: Pearl Harbor
State: Hawaii
ZIP Code: 96860
Phone: (530) 276-3389

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X
Dentist - Periodontics — Periodontics	1223P0300X	Primary

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