Keith David Johnson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

014182 Issued in MO

Practice address

26 S Village Dr
Liberty, MO 64068

Phone

(816) 781-7571

Fax

(816) 781-7933

NPI assigned

Aug 8, 2007

Last updated

Aug 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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.

• Keith D Johnson DDS PC

  • Dentist
  • Liberty, MO
  • NPI 1164599452
  Authorized official Same address or phone

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186531200000",
    "number": "1336330810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7912 NW BARR LANE",
            "city": "KC",
            "state": "MO",
            "postal_code": "64152",
            "telephone_number": "816-746-6246",
            "fax_number": "816-781-7933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26 S VILLAGE DR",
            "city": "LIBERTY",
            "state": "MO",
            "postal_code": "64068",
            "telephone_number": "816-781-7571",
            "fax_number": "816-781-7933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KEITH",
        "middle_name": "DAVID",
        "name_prefix": "Mr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-08",
        "last_updated": "2007-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "014182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carissa Lynn Johnson
• Chelsea Dawn Johnson, M.D.
• Diana Johnson, L.P.C.
• Garrett Allen Johnson, PT, DPT
• Jude Alexander Johnson
• Leigh Ann Johnson, PA-C
• Morgan Johnson
• Maren Johnston
• Elaina Jones
• Julie Jeanette Jones, DPM

• General Practice Dentistry in Liberty, MO
• Providers in Liberty, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2007; 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.