Matthew L Johnson, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

8486 Issued in KY

Practice address

722 Harvard Dr
Owensboro, KY 42301-6152

Phone

(270) 685-5242

Fax

(270) 685-5247

NPI assigned

Sep 11, 2007

Last updated

Nov 10, 2009By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Johnson Family Dentistry

  • Dentist
  • Owensboro, KY
  • NPI 1255752614
  NPD (past) Authorized official

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

{
    "created_epoch": "1189468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1257811200000",
    "number": "1295920411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "722 HARVARD DR",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423016152",
            "telephone_number": "270-685-5242",
            "fax_number": "270-685-5247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "722 HARVARD DR",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423016152",
            "telephone_number": "270-685-5242",
            "fax_number": "270-685-5247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MATTHEW",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-11",
        "last_updated": "2009-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "8486",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "KY8486",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordon Johnson, LMSW
• Julie B Johnson, LPCC
• Kimberly Janell Johnson
• Kyle Gregory Johnson, APRN FNP-C
• Matthew C Johnson, APRN
• Michelle Johnson, LCSW
• Michelle L Johnson, CSA
• Monica Johnson, APRN
• Rayana E Johnson, MD
• Ronald M Johnson, MD

• Dentist in Owensboro, KY
• Providers in Owensboro, KY by specialty
• Dentist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2009; 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.