Johnson Family Dental, LLC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

019028015 Issued in IL

Legal business name

JOHNSON FAMILY DENTAL, LLC

Practice address

2525 W Iles Ave
Springfield, IL 62704-4283

Phone

(217) 787-7744

NPI assigned

Dec 12, 2012

Organization subpart

No

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

Authorized official

Name

Ryan D Johnson, D.M.D.

Title

Dentist

Phone

(217) 787-7744

Specialties & licenses 1

Addresses

Other names 1

• Johnson and Johnson Family Dentistry Doing business as

Locations

Practitioners 1

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

• Gary Vandekerckhove, D.D.S

  • General Practice Dentistry
  • Springfield, IL
  • NPI 1790893493
  NPD (past)

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

{
    "created_epoch": "1355270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355270400000",
    "number": "1194061564",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 W ILES AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044283",
            "telephone_number": "217-787-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 W ILES AVE",
            "city": "SPRINGFIELD",
            "state": "IL",
            "postal_code": "627044283",
            "telephone_number": "217-787-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON FAMILY DENTAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-12",
        "last_updated": "2012-12-12",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "217-787-7744",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019028015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Johnson and Johnson Family Dentistry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Lixia Jia, PHARMACIST
• JMJ Dental, Inc
• John M. Colbert, DMD, LLC
• Ashish John, MD
• Teena John, MD
• Alicia R Johnson, MHT
• Amelia Johnson
• Andrea N. Johnson, LCPC
• Angel Johnson
• Anton Johnson, M.D.

• General Practice Dentistry in Springfield, IL
• Providers in Springfield, IL by specialty
• General Practice Dentistry in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2012; 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.