Individual provider Active NPI

John Robinson Jr., DDS

  • General Practice Dentistry
  • Columbus, MS
National Provider Identifier
1053416370
Registry record updated Jan 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1914-80 Issued in MS
Practice address
1111 5TH Ave North
Columbus, MS 39701
Phone
(662) 328-7941
Fax
(662) 328-4789
NPI assigned
Sep 13, 2006
Last updated
Jan 12, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2017

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 1914-80 MS
General Practice Dentistry 1223G0001X 1914-80 MS Primary

Addresses

Primary practice location

1111 5TH Ave North
Columbus, MS 39701

Mailing address

1111 5TH Ave North
Columbus, MS 39701
Phone (662) 328-7941

Other identifiers 1

IdentifierTypeStateIssuer
00064863MedicaidMS

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

LicenseStateTypeSpecialty
1914-80MSMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484179200000",
    "number": "1053416370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 5TH AVE NORTH",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "39701",
            "telephone_number": "662-328-7941",
            "fax_number": "662-328-4789"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 5TH AVE NORTH",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "39701",
            "telephone_number": "662-328-7941",
            "fax_number": "662-328-4789"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBINSON",
        "first_name": "JOHN",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-13",
        "last_updated": "2017-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MS",
            "license": "1914-80",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "1914-80",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00064863",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2017; 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.