Paul David Johnson, DMD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN14870 Issued in FL

Practice address

25 Pine Cone Drive
Suite 1
Palm Coast, FL 32164

Phone

(386) 445-7671

Fax

(386) 445-7278

NPI assigned

Mar 4, 2008

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1204588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204588800000",
    "number": "1023288255",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 PINE CONE DRIVE",
            "address_2": "SUITE 1",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "32164",
            "telephone_number": "386-445-7671",
            "fax_number": "386-445-7278"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 PINE CONE DRIVE",
            "address_2": "SUITE 1",
            "city": "PALM COAST",
            "state": "FL",
            "postal_code": "32164",
            "telephone_number": "386-445-7671",
            "fax_number": "386-445-7278"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PAUL",
        "middle_name": "DAVID",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-04",
        "last_updated": "2008-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DN14870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John G Symeonides M D LLC
• Johnny Bernard Jr MD LLC
• Jeanette Deloris Johnson
• Katherine Anne Johnson
• Lisa Johnson, LCSW
• Victoria C Johnson
• Eloise Johnston, OTR/L
• Garett Taylor Johnston, DMD
• Gregory Ackert Johnston, D.D.S.
• Jordan Scott Johnston, DMD

• All providers in Palm Coast, FL
• Orthodontics and Dentofacial Orthopedics Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2008; 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.