Justin Lee Johnson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2007016529 Issued in MO

Practice address

3551 Amazonas Dr
Jefferson City, MO 65109-5717

Phone

(573) 634-2400

NPI assigned

Jun 15, 2007

Sex

Male

Sole proprietor

No

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": "1181865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1398643200000",
    "number": "1053516658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3551 AMAZONAS DR",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651095717",
            "telephone_number": "573-634-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3551 AMAZONAS DR",
            "city": "JEFFERSON CITY",
            "state": "MO",
            "postal_code": "651095717",
            "telephone_number": "573-634-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JUSTIN",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-15",
        "last_updated": "2014-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2007016529",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bryan Karl Johnson, PHARMD
• Ebony L Johnson, PT
• Grover Cleveland Johnson IV
• Hannah N Johnson, LCSW
• Jennifer Marie Johnson, M.A., LPC
• Lauren Johnson
• Marti Johnson
• Paula Hancock Johnson, LCSW
• Tina Johnson
• Jokerst Chiropractic Health Center

• General Practice Dentistry in Jefferson City, MO
• Providers in Jefferson City, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2014; 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.