Kevin Darnell Johnson, DDS

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

DI20215 Issued in NJ

Practice address

71 Valley St
Suite103
South Orange, NJ 07079-2835

Phone

(973) 378-2070

NPI assigned

Feb 9, 2007

Last updated

Jul 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

Practice roles

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.

• South Mountain Dental Specialty Group

  • Periodontics
  • South Orange, NJ
  • NPI 1063634137
  NPD (past)

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366583841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 FENFIELD CT",
            "city": "HAMBURG",
            "state": "NJ",
            "postal_code": "074191268",
            "telephone_number": "973-209-4384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 VALLEY ST",
            "address_2": "SUITE103",
            "city": "SOUTH ORANGE",
            "state": "NJ",
            "postal_code": "070792835",
            "telephone_number": "973-378-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KEVIN",
        "middle_name": "DARNELL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-09",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "NJ",
            "license": "DI20215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jespy House Inc.
• Jespy House Inc.
• Jespy House Inc.
• Jespy House Inc.
• Jewish Community Housing Corporation of Metropolitan New Jersey (JCHC Alp)
• Melissa Marie Johnson, MA, LPC, NCC, ATR
• Natashia Johnson
• Rashaneegon Johnson, LPC
• Jasmine Joseph, PA-C
• Kellianne Josephsen, DPT

• Endodontics in South Orange, NJ
• Providers in South Orange, NJ by specialty
• Endodontics in New Jersey

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