Active NPI
Neal Antonio Johnson, DDS
- Dental Anesthesiology
- Yucaipa, CA
National Provider Identifier
1043474471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Anesthesiology
- License
- 2062
- Practice address
- 34366 Yucaipa Blvd Ste K
Yucaipa, CA 92399-2497 - Phone
- (909) 797-9247
- Fax
- (909) 354-3767
- NPI assigned
- Jul 15, 2008
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 57259 | CA | |
| Dental Anesthesiology | 1223D0004X | 2062 | MT | Primary |
Addresses
Primary practice location
34366 Yucaipa Blvd Ste K
Yucaipa, CA 92399-2497
Mailing address
34366 Yucaipa Blvd Ste K
Yucaipa, CA 92399-2497
Phone (909) 797-9247
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2062 | MT | MD | Geriatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jorge Enciso, DDS, Inc. | Current | Accepting new patients | |
| Neal a Johnson DDS Inc. | Dental Anesthesiology | Current | Accepting new patients |
Locations
34366 Yucaipa Blvd
Ste K
Yucaipa, CA 92399
Phone (909) 754-5659
Organizations & group practices 2
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.
-
- Dental Clinic/Center
- Yucaipa, CA
- NPI 1447829338
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1216080000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1714003200000",
"number": "1043474471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34366 YUCAIPA BLVD STE K",
"city": "YUCAIPA",
"state": "CA",
"postal_code": "923992497",
"telephone_number": "909-797-9247",
"fax_number": "909-354-3767"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34366 YUCAIPA BLVD STE K",
"city": "YUCAIPA",
"state": "CA",
"postal_code": "923992497",
"telephone_number": "909-797-9247",
"fax_number": "909-354-3767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "NEAL",
"middle_name": "ANTONIO",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-07-15",
"last_updated": "2024-04-25",
"certification_date": "2023-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "CA",
"license": "57259",
"primary": false
},
{
"code": "1223D0004X",
"taxonomy_group": "",
"desc": "Dentist, Dental Anesthesiology",
"state": "MT",
"license": "2062",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yucaipa, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.