NPIMap

Organization Active NPI

M. Andrew Johnson D.D.S. LC

  • General Practice Dentistry
  • Logan, UT
National Provider Identifier
1255766820
Registry record updated Sep 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
141633 9921 Issued in UT
Legal business name
M. ANDREW JOHNSON D.D.S. LC
Practice address
1153 N Main St
Suite B-150
Logan, UT 84341-2495
Phone
(435) 752-2153
NPI assigned
Sep 13, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2013

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

Authorized official

Name
Dr. M Andrew Johnson, D.D.S.
Title
Manager
Phone
(435) 753-2153

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 141633 9921 UT Primary

Addresses

Primary practice location

1153 N Main St
Suite B-150
Logan, UT 84341-2495

Mailing address

41 East 400 North
#338
Logan, UT 84321
Phone (435) 752-2153

National Provider Directory

National Provider Directory

Locations

1153 N Main St
Ste B150
Logan, UT 84341
Phone (435) 752-2153

NPI Registry JSON

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

{
    "created_epoch": "1379030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1379030400000",
    "number": "1255766820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "41 EAST 400 NORTH",
            "address_2": "#338",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "84321",
            "telephone_number": "435-752-2153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1153 N MAIN ST",
            "address_2": "SUITE B-150",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412495",
            "telephone_number": "435-752-2153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M. ANDREW JOHNSON D.D.S. LC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-09-13",
        "last_updated": "2013-09-13",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "M",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "435-753-2153",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": "141633 9921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2013; 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.