Connor Scott Johnson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12591 Issued in NC

Practice address

7476 Waterside Loop Rd Ste 100
Denver, NC 28037-7680

Phone

(704) 820-9797

NPI assigned

Oct 5, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Frank Avason III, DMD, Ms, PA

  • Dental Clinic/Center
  • Denver, NC
  • NPI 1033374269
  NPD (past)

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

{
    "created_epoch": "1570233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647129600000",
    "number": "1013558519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4509 ARGONNE CT",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230606443",
            "telephone_number": "804-252-1976"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7476 WATERSIDE LOOP RD STE 100",
            "city": "DENVER",
            "state": "NC",
            "postal_code": "280377680",
            "telephone_number": "704-820-9797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CONNOR",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-05",
        "last_updated": "2022-03-13",
        "certification_date": "2022-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "9594",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NC",
            "license": "12591",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kendra Jackson, NP
• Kimberly Jackson, DNP, FNP-BC
• Wyllis Eugene James Jr., DDS
• Kathryn Jansen, NP
• Jeffrey W. Lineberry, DDS, PLLC
• Margaret Waldrup Johnson, MT-BC
• Courtney S Jones, LCSW
• Gary S. Jones, DDS, PA
• Jessica Swann Jones, DO
• Jill P Josephson, MD

• General Practice Dentistry in Denver, NC
• Providers in Denver, NC by specialty
• General Practice Dentistry in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.