Individual provider Active NPI

Jeff Johnston, D.D.S.

  • Dentist
  • Glendale, CO
National Provider Identifier
1235207200
Registry record updated Mar 7, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
9096 Issued in CO
Practice address
4500 E Cherry Creek Dr South
100
Glendale, CO 80246-7911
Phone
(303) 975-6987
Fax
(303) 678-8986
NPI assigned
Nov 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 9096 CO Primary

Addresses

Primary practice location

4500 E Cherry Creek Dr South
100
Glendale, CO 80246-7911

Mailing address

4500 E Cherry Creek South Dr.
100
Denver, CO 80246-5946
Phone (303) 975-6987

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150709001589 CO Order and Referring Only - Oral SurgeryPractitioner - Oral Surgery 4486966199

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9096COMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Jeff Johnston DDS PC Past Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488844800000",
    "number": "1235207200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4500 E CHERRY CREEK SOUTH DR.",
            "address_2": "100",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "802465946",
            "telephone_number": "303-975-6987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4500 E CHERRY CREEK DR SOUTH",
            "address_2": "100",
            "city": "GLENDALE",
            "state": "CO",
            "postal_code": "802467911",
            "telephone_number": "303-975-6987",
            "fax_number": "303-678-8986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSTON",
        "first_name": "JEFF",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-30",
        "last_updated": "2017-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "9096",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Glendale, CO

Sources for this page

Verify at the official NPI Registry.