The Dentists Clinic

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D 829 Issued in GU

Legal business name

THE DENTISTS CLINIC

Practice address

761 S Marine Corps Drive
Suite a-2 Centam Building
Tamuning, GU 96913

Phone

(671) 646-7982

Fax

(671) 646-7989

NPI assigned

Aug 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jeffrey Charles Johnson, DDS

Title

General Partner

Phone

(671) 646-7982

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• ISA Dental Doing business as

Locations

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

{
    "created_epoch": "1188259200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1188259200000",
    "number": "1093909558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX W",
            "city": "HAGATNA",
            "state": "GU",
            "postal_code": "96932",
            "telephone_number": "671-646-7982",
            "fax_number": "671-646-7989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "761 S MARINE CORPS DRIVE",
            "address_2": "SUITE A-2 CENTAM BUILDING",
            "city": "TAMUNING",
            "state": "GU",
            "postal_code": "96913",
            "telephone_number": "671-646-7982",
            "fax_number": "671-646-7989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE DENTISTS CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-28",
        "last_updated": "2007-08-28",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "GENERAL PARTNER",
        "authorized_official_telephone_number": "671-646-7982",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "GU",
            "license": "D 829",
            "primary": true
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GU",
            "license": "D 901",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAWAII DENTAL SERVICES",
            "identifier": "555029",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "185",
            "state": "GU"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ISA Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Laura Taylor, M.D.
• Sonita Chuo Tem, MD
• Ricardo Mark Terlaje, M.D.
• Mo-Ping Marlene Tham, DO
• Kamala Thanapandian, MD
• The Doctors Clinic
• The Doctors' Clinic
• The Offices of Ramel a Carlos MD Inc
• The Pediatric & Adolescents Clinic Inc.
• The Weingarten Institute for Neuroscience, Inc.

• All providers in Tamuning, GU
• General Practice Dentistry in Guam

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2007; 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.