NPIMap

Organization Active NPI

Peter F Johnson DMD a Professional Corporation

  • Prosthodontics
  • La Mesa, CA
National Provider Identifier
1023334711
Registry record updated Jun 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthodonticsTaxonomy code 1223P0700X
License
D25550 Issued in CA
Legal business name
PETER F JOHNSON DMD A PROFESSIONAL CORPORATION
Practice address
5565 Grossmont Center Dr
Suite 110-1
La Mesa, CA 91942-3020
Phone
(619) 463-3737
Fax
(619) 463-3730
NPI assigned
Apr 20, 2010
Last updated
Jun 22, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2010

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

Authorized official

Name
Dr. Peter Fink Johnson, D.M.D.NPI 1518907658
Title
President
Phone
(619) 463-3737

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthodontics 1223P0700X D25550 CA Primary

Addresses

Primary practice location

5565 Grossmont Center Dr
Suite 110-1
La Mesa, CA 91942-3020

Mailing address

5565 Grossmont Center Dr
Suite 110-1
La Mesa, CA 91942-3020
Phone (619) 463-3737

Other identifiers 1

IdentifierTypeStateIssuer
D25550OtherCAPTAN

National Provider Directory

National Provider Directory

Locations

5565 Grossmont Center Dr
Ste 110
La Mesa, CA 91942
Phone (619) 463-3737

5565 Grossmont Center Dr
Ste 1101
La Mesa, CA 91942
Phone (619) 463-3737

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277164800000",
    "number": "1023334711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5565 GROSSMONT CENTER DR",
            "address_2": "SUITE 110-1",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423020",
            "telephone_number": "619-463-3737",
            "fax_number": "619-463-3730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5565 GROSSMONT CENTER DR",
            "address_2": "SUITE 110-1",
            "city": "LA MESA",
            "state": "CA",
            "postal_code": "919423020",
            "telephone_number": "619-463-3737",
            "fax_number": "619-463-3730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETER F JOHNSON DMD A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-20",
        "last_updated": "2010-06-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "PETER",
        "authorized_official_middle_name": "FINK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "619-463-3737",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "CA",
            "license": "D25550",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "D25550",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in La Mesa, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2010; 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.