Individual provider Active NPI

Jessica Brooke Johnson, DDS

  • General Practice Dentistry
  • Des Moines, IA
National Provider Identifier
1245487859
Registry record updated Aug 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
8486 Issued in IA
Practice address
1111 9TH St Ste 190
Des Moines, IA 50314-2527
Phone
(515) 244-9136
Fax
(515) 244-9153
NPI assigned
Aug 26, 2008
Last updated
Aug 26, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 8486 IA Primary

Addresses

Primary practice location

1111 9TH St Ste 190
Des Moines, IA 50314-2527

Mailing address

1111 9TH St Ste 190
Des Moines, IA 50314-2527
Phone (515) 244-9136

Other names 1

  • Jessica Brooke Laughlin Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
8486IAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1219708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1245487859",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 9TH ST STE 190",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503142527",
            "telephone_number": "515-244-9136",
            "fax_number": "515-244-9153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 9TH ST STE 190",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503142527",
            "telephone_number": "515-244-9136",
            "fax_number": "515-244-9153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JESSICA",
        "middle_name": "BROOKE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-26",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "8486",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "LAUGHLIN",
            "middle_name": "BROOKE",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; 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.