Candice Rae Johnson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

49046 Issued in CA

Practice address

5512 E Britton Dr
Suite 208
Long Beach, CA 90815-3146

Phone

(562) 594-7100

Fax

(562) 594-8800

NPI assigned

May 16, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Candice R. Johnson DDS Brian K. Shimizu DDS

  • Dentist
  • Long Beach, CA
  • NPI 1043651383
  NPD (past) Authorized official

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

{
    "created_epoch": "1179273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376956800000",
    "number": "1295941003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5512 E BRITTON DR",
            "address_2": "SUITE 208",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908153146",
            "telephone_number": "562-594-7100",
            "fax_number": "562-594-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5512 E BRITTON DR",
            "address_2": "SUITE 208",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908153146",
            "telephone_number": "562-594-7100",
            "fax_number": "562-594-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CANDICE",
        "middle_name": "RAE",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-16",
        "last_updated": "2013-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CA",
            "license": "49046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "841649733",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexander Johnson, DO
• Alexis Johnson
• Alvis L Johnson II, LVN
• Alyson Johnson
• Ayana Takeia Johnson
• Cassidy Johnson, DC
• Charee Johnson
• Coulsander Johnson
• Courtney Victoria Johnson, PMHNP
• Crystal Mae Johnson, PTA

• General Practice Dentistry in Long Beach, CA
• Providers in Long Beach, CA by specialty
• General Practice Dentistry in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.