Active NPI
Kent B Johnson, D.D.S.
- Dentist
- Hesperia, CA
National Provider Identifier
1104079664
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 35275
- Practice address
- 9176 I Ave
Hesperia, CA 92345-6526 - Phone
- (760) 244-2027
- Fax
- (760) 244-0361
- NPI assigned
- Oct 28, 2008
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Dentist | 122300000X | 35275 | CA | Primary |
Addresses
Primary practice location
9176 I Ave
Hesperia, CA 92345-6526
Mailing address
9176 I Ave
Hesperia, CA 92345-6526
Phone (760) 244-2027
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 |
|---|---|---|---|
| 35275 | CA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Merle W. Johnson, D.D.S., Inc. | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- General Practice Dentistry
- Hesperia, CA
- NPI 1033445374
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225152000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1256083200000",
"number": "1104079664",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9176 I AVE",
"city": "HESPERIA",
"state": "CA",
"postal_code": "923456526",
"telephone_number": "760-244-2027",
"fax_number": "760-244-0361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9176 I AVE",
"city": "HESPERIA",
"state": "CA",
"postal_code": "923456526",
"telephone_number": "760-244-2027",
"fax_number": "760-244-0361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KENT",
"middle_name": "B",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2008-10-28",
"last_updated": "2009-10-21",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "35275",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hesperia, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.