Active NPI
Joshua W. Johnson
- Dentist
- San Diego, CA
National Provider Identifier
1083134480
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- D009722
- Practice address
- 2841 Rendova Rd
San Diego, CA 92155-5490 - Phone
- (619) 556-4157
- NPI assigned
- Jun 27, 2017
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | D009722 | AZ | Primary |
Addresses
Primary practice location
2841 Rendova Rd
San Diego, CA 92155-5490
Mailing address
Uss Tripoli
Box #3887
Fpo, AP 96694-0000
Other practice location 1
2310 Craven St Bldg 3230
San Diego, CA 92136-5596
Phone (619) 556-8252
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 |
|---|---|---|---|
| D009722 | AZ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1498521600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1724803200000",
"number": "1083134480",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "MIL",
"address_1": "USS TRIPOLI",
"address_2": "BOX #3887",
"city": "FPO",
"state": "AP",
"postal_code": "966940000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2841 RENDOVA RD",
"city": "SAN DIEGO",
"state": "CA",
"postal_code": "921555490",
"telephone_number": "619-556-4157"
}
],
"practiceLocations": [
{
"address_1": "2310 Craven St Bldg 3230",
"address_purpose": "LOCATION",
"city": "San Diego",
"state": "CA",
"postal_code": "921365596",
"country_code": "US",
"telephone_number": "619-556-8252",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "JOSHUA",
"middle_name": "W.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2017-06-27",
"last_updated": "2024-08-28",
"certification_date": "2024-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist",
"state": "AZ",
"license": "D009722",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Diego, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.