Active NPI
Frederick Stephen Johnson, DMD
- Dentist
- Cleona, PA
National Provider Identifier
1003985524
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- DS020635L
- Practice address
- 221 W Penn Ave
Ste 213
Cleona, PA 17042 - Phone
- (717) 272-8500
- Fax
- (717) 272-6101
- NPI assigned
- Nov 7, 2006
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | DS020635L | PA | Primary |
Addresses
Primary practice location
221 W Penn Ave
Ste 213
Cleona, PA 17042
Mailing address
2071 Gramercy Place
Hummelstown, PA 17036
Phone (717) 269-9711
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DS020635L | PA | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162857600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1003985524",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2071 GRAMERCY PLACE",
"city": "HUMMELSTOWN",
"state": "PA",
"postal_code": "17036",
"telephone_number": "717-269-9711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "221 W PENN AVE",
"address_2": "STE 213",
"city": "CLEONA",
"state": "PA",
"postal_code": "17042",
"telephone_number": "717-272-8500",
"fax_number": "717-272-6101"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "FREDERICK",
"middle_name": "STEPHEN",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-07",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "PA",
"license": "DS020635L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleona, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.