Abbassi Johnson Professional Corporation

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

OMS36 Issued in CA

Legal business name

ABBASSI JOHNSON PROFESSIONAL CORPORATION

Doing business as

N/a

Practice address

558 W Badillo St
Covina, CA 91722

Phone

(626) 331-0506

Fax

(626) 858-1788

NPI assigned

Oct 5, 2011

Last updated

Oct 5, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Arthur Johnson III, MD, DDS

Title

Owner

Phone

(626) 331-0506

Specialties & licenses 6

Addresses

Other names 1

• N/A Doing business as

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

{
    "created_epoch": "1317772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1317772800000",
    "number": "1255615522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "558 W BADILLO ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "917223762",
            "telephone_number": "626-331-0506",
            "fax_number": "626-858-1788"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "558 W BADILLO ST",
            "city": "COVINA",
            "state": "CA",
            "postal_code": "91722",
            "telephone_number": "626-331-0506",
            "fax_number": "626-858-1788"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ABBASSI JOHNSON PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-05",
        "last_updated": "2011-10-05",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ARTHUR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "626-331-0506",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "MD, DDS"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CA",
            "license": "54047",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "55948",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "54322",
            "primary": false
        },
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "47476",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "24358",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CA",
            "license": "OMS36",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "N/A",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Oral and Maxillofacial Surgery (Dentist) in Covina, CA
• Providers in Covina, CA by specialty
• Oral and Maxillofacial Surgery (Dentist) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2011; 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.