Shannon P Johnson DMD PLLC

Primary specialty

DentistTaxonomy code 122300000X

Legal business name

SHANNON P JOHNSON DMD PLLC

Practice address

9513 Whipps Mill Rd
Louisville, KY 40242-3640

Phone

(502) 805-0500

Fax

(502) 771-6041

NPI assigned

Feb 9, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Shannon Polly Johnson, DMDNPI 1598975971

Title

President

Phone

(502) 957-9390

Specialties & licenses 2

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Shannon Polly Johnson, DMD

  • Dentist
  • Louisville, KY
  • NPI 1598975971
  NPD Authorized official

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

{
    "created_epoch": "1581206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784937600000",
    "number": "1316579279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9513 WHIPPS MILL RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402423640",
            "telephone_number": "502-805-0500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9513 WHIPPS MILL RD",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402423640",
            "telephone_number": "502-805-0500",
            "fax_number": "502-771-6041"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHANNON P JOHNSON DMD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-09",
        "last_updated": "2026-07-25",
        "certification_date": "2026-07-25",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "SHANNON",
        "authorized_official_middle_name": "POLLY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "502-957-9390",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Charles B Shane, M.D.
• Whoy Yurn Shang, APRN
• Angela Kay Shanks, COTA/L
• Jennifer Shanks, LCSW, LCADC
• Shannon M Barnett (Hands of Love)
• Shannon S. Voor, PH.D., PLLC
• Andrea Marie Shannon
• Diana Shannon
• John Stuart Shannon
• Dana Shanton

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2026; 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.