Richard S Johnson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

5909098 Issued in UT

Practice address

South Valley Family Dental Dr. Richard S. Johnson DDS
271 N. Springcreek Pkwy Suite D
Providence, UT 84332-9875

Phone

(435) 787-2122

Fax

(435) 755-6797

NPI assigned

Jul 31, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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.

• Redwood Dental PDC PLLC

  • Dental Clinic/Center
  • Providence, UT
  • NPI 1881317535
  NPD (past)

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1023024064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "SOUTH VALLEY FAMILY DENTAL DR. RICHARD S. JOHNSON DDS",
            "address_2": "271 N. SPRINGCREEK PKWY SUITE D",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843329875",
            "telephone_number": "435-787-2122",
            "fax_number": "435-755-6797"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "SOUTH VALLEY FAMILY DENTAL DR. RICHARD S. JOHNSON DDS",
            "address_2": "271 N. SPRINGCREEK PKWY SUITE D",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843329875",
            "telephone_number": "435-787-2122",
            "fax_number": "435-755-6797"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RICHARD",
        "middle_name": "S",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "5909098",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX I.D. #",
            "identifier": "202830421",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF UTAH LICENSE",
            "identifier": "5909098",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jordyn Jay, RBT
• Dylan Wyatt Jensen, RBT
• Wylee Kyle Jensen, APRN, FNP-C
• Jess Henry Jewett, M.D.
• JHJ Wound Care PLLC
• Devyn Jones
• Kasaundra D Jorgensen, RBT
• Elisabeth Ann Juhasz
• Benjamin R Kadas, APN
• McKensie Kaplan, LCSW

• All providers in Providence, UT
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.