Thomas B Johnson DMD PLLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00011072 Issued in WA

Legal business name

THOMAS B JOHNSON DMD PLLC

Doing business as

KETTLE FALLS FAMILY DENTISTRY

Practice address

130 W 10TH Ave
Kettle Falls, WA 99141-8666

Phone

(509) 738-6880

Fax

(509) 738-6824

NPI assigned

Feb 2, 2016

Organization subpart

No

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

Authorized official

Name

Dr. Thomas B Johnson, DMDNPI 1558555821

Title

Owner

Phone

(509) 738-6880

Specialties & licenses 1

Addresses

Other names 1

• KETTLE FALLS FAMILY DENTISTRY Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Thomas B Johnson, DMD

  • Dentist
  • Kettle Falls, WA
  • NPI 1558555821
  NPD (past) Authorized official
• Jason C Keefe, D.D.S.

  • General Practice Dentistry
  • Kettle Falls, WA
  • NPI 1841347416
  NPD (past)

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

{
    "created_epoch": "1454371200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454371200000",
    "number": "1184082455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 W 10TH AVE",
            "city": "KETTLE FALLS",
            "state": "WA",
            "postal_code": "991418666",
            "telephone_number": "509-738-6880",
            "fax_number": "509-738-6824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W 10TH AVE",
            "city": "KETTLE FALLS",
            "state": "WA",
            "postal_code": "991418666",
            "telephone_number": "509-738-6880",
            "fax_number": "509-738-6824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THOMAS B JOHNSON DMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-02",
        "last_updated": "2016-02-02",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "509-738-6880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00011072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "KETTLE FALLS FAMILY DENTISTRY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Providence Health & Services Washington
• Janis Pruitt-Hamm, MA, LMHC
• Susan Lee Ridlington, PT
• Donna Bedgood Rosen, PHD
• Avery Anne Shelden, LMT
• Steven Tingey
• Valley Drug Co
• Rhett W Weilep, D.C.
• Craig Wolfe, DO

• General Practice Dentistry in Kettle Falls, WA
• Providers in Kettle Falls, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2016; 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.