NPIMap

Organization Active NPI

John M Johnson DDS PC

  • Dentist
  • Groton, CT
National Provider Identifier
1235269689
Registry record updated Jun 30, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
6800 Issued in CT
Legal business name
JOHN M JOHNSON DDS PC
Practice address
643 Gold Star Hwy
Groton, CT 06340-6267
Phone
(860) 445-8569
Fax
(860) 446-8434
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2009

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

Authorized official

Name
Dr. John M Johnson, DDSNPI 1336141068
Title
Owner President
Phone
(860) 445-8569

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 6800 CT Primary

Addresses

Primary practice location

643 Gold Star Hwy
Groton, CT 06340-6267

Mailing address

643 Gold Star Hwy
Groton, CT 06340-6267
Phone (860) 445-8569

National Provider Directory

National Provider Directory

Locations

643 Route 184
Groton, CT 06340
Phone (860) 445-8569

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1246320000000",
    "number": "1235269689",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "643 GOLD STAR HWY",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063406267",
            "telephone_number": "860-445-8569",
            "fax_number": "860-446-8434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "643 GOLD STAR HWY",
            "city": "GROTON",
            "state": "CT",
            "postal_code": "063406267",
            "telephone_number": "860-445-8569",
            "fax_number": "860-446-8434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHN M JOHNSON DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2009-06-30",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "860-445-8569",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CT",
            "license": "6800",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Groton, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2009; 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.