NPIMap

Organization Active NPI

J. Grant Johansen DMD PLLC

  • Dental Clinic/Center
  • Chandler, AZ
National Provider Identifier
1316416621
Registry record updated Nov 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
J. GRANT JOHANSEN DMD PLLC
Practice address
3800 W Ray Rd Ste 11
Chandler, AZ 85226-5940
Phone
(480) 345-0530
Fax
(480) 345-0048
NPI assigned
Nov 15, 2018
Last updated
Nov 15, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 15, 2018

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

Authorized official

Name
Dr. Justin Grant Johansen, DMD, MPHNPI 1215318977
Title
Dentist, Owner
Phone
(480) 254-6712

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
Dental Clinic/Center 261QD0000X NU Primary

Addresses

Primary practice location

3800 W Ray Rd Ste 11
Chandler, AZ 85226-5940

Mailing address

3800 W Ray Rd Ste 11
Chandler, AZ 85226-5940
Phone (480) 345-0530

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1542240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1542240000000",
    "number": "1316416621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 W RAY RD STE 11",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852265940",
            "telephone_number": "480-345-0530",
            "fax_number": "480-345-0048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 W RAY RD STE 11",
            "city": "CHANDLER",
            "state": "AZ",
            "postal_code": "852265940",
            "telephone_number": "480-345-0530",
            "fax_number": "480-345-0048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "J. GRANT JOHANSEN DMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-15",
        "last_updated": "2018-11-15",
        "status": "A",
        "authorized_official_last_name": "JOHANSEN",
        "authorized_official_first_name": "JUSTIN",
        "authorized_official_middle_name": "GRANT",
        "authorized_official_title_or_position": "DENTIST, OWNER",
        "authorized_official_telephone_number": "480-254-6712",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD, MPH"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chandler, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2018; 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.