Active NPI
Emma Johnson Wood, DDS
- Periodontics
- San Deigo, CA
National Provider Identifier
1043835952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 11824
- Practice address
- BLDG 600 McCain Blvd
Branch Dental Clinic Naval Air Station North Island
San Deigo, CA 92135 - Phone
- (619) 545-6397
- NPI assigned
- Jun 16, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 11824 | NC | Primary |
Addresses
Primary practice location
BLDG 600 McCain Blvd
Branch Dental Clinic Naval Air Station North Island
San Deigo, CA 92135
Mailing address
BLDG 600 McCain Blvd
Branch Dental Clinic Naval Air Station North Island
San Deigo, CA 92135
Phone (619) 545-6397
Other names 1
- Emma Caitlin Johnson
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 |
|---|---|---|---|
| 11824 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1592265600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722556800000",
"number": "1043835952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "BLDG 600 MCCAIN BLVD",
"address_2": "BRANCH DENTAL CLINIC NAVAL AIR STATION NORTH ISLAND",
"city": "SAN DEIGO",
"state": "CA",
"postal_code": "92135",
"telephone_number": "619-545-6397"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "BLDG 600 MCCAIN BLVD",
"address_2": "BRANCH DENTAL CLINIC NAVAL AIR STATION NORTH ISLAND",
"city": "SAN DEIGO",
"state": "CA",
"postal_code": "92135",
"telephone_number": "619-545-6397"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOD",
"first_name": "EMMA",
"middle_name": "JOHNSON",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-16",
"last_updated": "2024-08-02",
"certification_date": "2024-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "NC",
"license": "11824",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "EMMA",
"last_name": "JOHNSON",
"middle_name": "CAITLIN",
"credential": "DDS",
"code": "1",
"type": "Former Name"
}
]
}Other providers in San Deigo, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 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.