James Frederick Johnson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

9072 Issued in MN

Practice address

512 NE 1St Ave
Grand Rapids, MN 55744-2610

Phone

(218) 326-2531

NPI assigned

Sep 15, 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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1245336841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "512 NE 1ST AVE",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557442610",
            "telephone_number": "218-326-2531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "512 NE 1ST AVE",
            "city": "GRAND RAPIDS",
            "state": "MN",
            "postal_code": "557442610",
            "telephone_number": "218-326-2531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JAMES",
        "middle_name": "FREDERICK",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "9072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD MN",
            "identifier": "71484JO",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kelley L Jensen, APRN, CNP
• Lee Dale Jess, D.D.S.
• John L Bonner Eye Clinic LTD
• Amber L. Johnson, CRNA
• David Johnson, RPH
• Kathryn Lynn Johnson
• Lanea D Johnson, OTR/L
• Lisa Mari Johnson, DDS
• Michael D. Johnson, MD
• Pamela M Johnson, MA LP

• General Practice Dentistry in Grand Rapids, MN
• Providers in Grand Rapids, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.