Justin Grant Johansen, D.M.D

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D009269 Issued in AZ

Practice address

3800 W Ray Rd Ste 11
Chandler, AZ 85226-5940

Phone

(480) 345-0530

NPI assigned

Jun 17, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• J. Grant Johansen DMD PLLC

  • Dental Clinic/Center
  • Chandler, AZ
  • NPI 1316416621
  NPD Authorized official

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

{
    "created_epoch": "1434499200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434499200000",
    "number": "1215318977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 W RAY RD STE 11",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852265940",
            "telephone_number": "480-345-0530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 W RAY RD STE 11",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852265940",
            "telephone_number": "480-345-0530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANSEN",
        "first_name": "JUSTIN",
        "middle_name": "GRANT",
        "name_prefix": "Dr.",
        "credential": "D.M.D",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-17",
        "last_updated": "2015-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "AZ",
            "license": "D009269",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ARIZONA STATE LICENSE",
            "identifier": "D009269",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathryn Jiminez
• Jjo Anesthesiology PC
• Jma Integrated Medicine PLLC
• Jnfox
• Joan Harper, M.D., P. C.
• Kent Johansen, DDS
• Martin Johansson, DPT
• John Patterson DMD PLC
• Kimberly K John
• Aaron Alma Johnson, D.D.S.

• General Practice Dentistry in Chandler, AZ
• Providers in Chandler, AZ by specialty
• General Practice Dentistry in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2015; 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.