Individual provider Active NPI

Angela J. Johnson, DDS

  • Dentist
  • Atlanta, GA
National Provider Identifier
1215009808
Registry record updated Nov 19, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DN011211 Issued in GA
Practice address
3915 Cascade Road Suite 120
Atlanta, GA 30331-2750
Phone
(404) 472-0425
Fax
(404) 472-0669
NPI assigned
Nov 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN011211 GA Primary

Addresses

Primary practice location

3915 Cascade Road Suite 120
Atlanta, GA 30331-2750

Mailing address

3915 Cascade Rd SW Ste 120
Atlanta, GA 30331-8519
Phone (404) 472-0425

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

LicenseStateTypeSpecialty
DN011211GAMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290124800000",
    "number": "1215009808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3915 CASCADE RD SW STE 120",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303318519",
            "telephone_number": "404-472-0425",
            "fax_number": "404-472-0669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3915 CASCADE ROAD SUITE 120",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303312750",
            "telephone_number": "404-472-0425",
            "fax_number": "404-472-0669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANGELA",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-15",
        "last_updated": "2010-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN011211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2010; 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.