PLJ PC

Primary specialty

DentistTaxonomy code 122300000X

License

D9406 Issued in OR

Legal business name

PLJ PC

Practice address

333 NW 3Rd Ave
Canby, OR 97013-3602

Phone

(503) 266-2705

Fax

(503) 266-2973

NPI assigned

Apr 5, 2010

Organization subpart

No

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

Authorized official

Name

Dr. Kevin Brooks Johnson, DMD

Title

Owner

Phone

(503) 266-2705

Specialties & licenses 1

Addresses

Other names 1

• Dr. Kevin B. Johnson Doing business as

Locations

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

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1334102400000",
    "number": "1346565165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 NW 3RD AVE",
            "city": "CANBY",
            "state": "OR",
            "postal_code": "970133602",
            "telephone_number": "503-266-2705",
            "fax_number": "503-266-2973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 NW 3RD AVE",
            "city": "CANBY",
            "state": "OR",
            "postal_code": "970133602",
            "telephone_number": "503-266-2705",
            "fax_number": "503-266-2973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLJ PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-05",
        "last_updated": "2012-04-11",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "BROOKS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "503-266-2705",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "OR",
            "license": "D9406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dr. Kevin B. Johnson",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Dentist in Canby, OR
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• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2012; 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.