Marlin S Johnson, D.M.D.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

0013177 Issued in GA

Practice address

215 Constitution Dr
Thomasville, GA 31757-4901

Phone

(229) 226-2386

Fax

(229) 226-9838

NPI assigned

Aug 20, 2006

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 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Thomasville Pediatric Dentistry

  • Pediatric Dentistry
  • Thomasville, GA
  • NPI 1518119718
  NPD (past) Authorized official

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476748800000",
    "number": "1235244906",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 CONSTITUTION DR",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317574901",
            "telephone_number": "229-226-2386",
            "fax_number": "229-226-9838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 CONSTITUTION DR",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317574901",
            "telephone_number": "229-226-2386",
            "fax_number": "229-226-9838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARLIN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-20",
        "last_updated": "2016-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "GA",
            "license": "0013177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197090698B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197090698C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "197090698A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John D. Archbold Memorial Hospital, Inc.
• John L. Taylor, Jr., M.D., PA
• Frederick Dwayne Johnson Jr., M.D.
• Jerry Steven Johnson, M.D.
• Kaila Nicole Johnson, PHARMD
• Michael Johnson, PT, DPT
• Quinetta L Johnson, MS
• Sarah Ardanuy Johnson, L.D.
• Stacey W Johnson, MD
• Jones Behavioral Health LLC

• Pediatric Dentistry in Thomasville, GA
• Providers in Thomasville, GA by specialty
• Pediatric Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.