Individual provider Active NPI

Carl Briner Johnston, DDS

  • General Practice Dentistry
  • Crossett, AR
National Provider Identifier
1003910159
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3154 Issued in AR
Practice address
909 A Unity Road
Crossett, AR 71635
Phone
(870) 364-3313
Fax
(870) 364-9433
NPI assigned
Sep 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 3154 AR Primary

Addresses

Primary practice location

909 A Unity Road
Crossett, AR 71635

Mailing address

PO Box 617
Crossett, AR 71635
Phone (870) 364-3313

Other identifiers 2

IdentifierTypeStateIssuer
704630OtherARUNITED CONCORDIA
59970OtherARBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AR
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160226000619 AR Order and Referring Only - DentistPractitioner - Dentist 1951606078

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Milton Johnston DDS PC General Practice Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1157932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003910159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 617",
            "city": "CROSSETT",
            "state": "AR",
            "postal_code": "71635",
            "telephone_number": "870-364-3313",
            "fax_number": "870-364-9433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 A UNITY ROAD",
            "city": "CROSSETT",
            "state": "AR",
            "postal_code": "71635",
            "telephone_number": "870-364-3313",
            "fax_number": "870-364-9433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "CARL",
        "middle_name": "BRINER",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AR",
            "license": "3154",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "704630",
            "state": "AR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "59970",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crossett, AR

Sources for this page

Verify at the official NPI Registry.