Active NPI
Johnny Johnson Jr., DMD
- Pediatric Dentistry
- Palm Harbor, FL
National Provider Identifier
1164595187
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DN9643
- Practice address
- 3840 Tampa Rd
Palm Harbor, FL 34684-3600 - Phone
- (727) 786-7551
- NPI assigned
- Nov 16, 2006
- 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 |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DN9643 | FL | Primary |
Addresses
Primary practice location
3840 Tampa Rd
Palm Harbor, FL 34684-3600
Mailing address
461 Waterford Cir E
Tarpon Springs, FL 34688-7206
Phone (727) 938-9322
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 |
|---|---|---|---|
| DN9643 | FL | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163635200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1164595187",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "461 WATERFORD CIR E",
"city": "TARPON SPRINGS",
"state": "FL",
"postal_code": "346887206",
"telephone_number": "727-938-9322"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3840 TAMPA RD",
"city": "PALM HARBOR",
"state": "FL",
"postal_code": "346843600",
"telephone_number": "727-786-7551"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "JOHNNY",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "DMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-11-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "FL",
"license": "DN9643",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Palm Harbor, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.