Organization Active NPI

Johnny M. Griffin DDS PC

  • General Practice Dentistry
  • Montgomery, AL
National Provider Identifier
1275872426
Registry record updated Feb 17, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
3420 Issued in AL
Legal business name
JOHNNY M. GRIFFIN DDS PC
Practice address
1401 I85 Pkwy Ste D
Montgomery, AL 36106-2833
Phone
(334) 274-9861
Fax
(334) 274-9863
NPI assigned
Feb 7, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2015

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

Authorized official

Name
Dr. Johnny Mack Griffin, DDSNPI 1982701348
Title
President
Phone
(334) 274-9861

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
General Practice DentistryGroup: 193400000X SINGLE SPECIALTY GROUP 1223G0001X 3420 AL Primary

Addresses

Primary practice location

1401 I85 Pkwy Ste D
Montgomery, AL 36106-2833

Mailing address

1401 I85 Pkwy Ste D
Montgomery, AL 36106-2833
Phone (334) 274-9861

Other identifiers 1

IdentifierTypeStateIssuer
009901290MedicaidAL

National Provider Directory

National Provider Directory

Locations

1401 I85 Pkwy
Ste D
Montgomery, AL 36106
Phone (334) 274-9861

Practitioners & affiliated clinicians

Practitioners 1

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": "1360195200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1424131200000",
    "number": "1275872426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 I85 PKWY STE D",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361062833",
            "telephone_number": "334-274-9861",
            "fax_number": "334-274-9863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 I85 PKWY STE D",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361062833",
            "telephone_number": "334-274-9861",
            "fax_number": "334-274-9863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNNY M. GRIFFIN DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-02-07",
        "last_updated": "2015-02-17",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "JOHNNY",
        "authorized_official_middle_name": "MACK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "334-274-9861",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "AL",
            "license": "3420",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "009901290",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2015; 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.