Individual provider Active NPI

Gary John Johnson, DDS

  • Endodontics
  • Chambersburg, PA
National Provider Identifier
1366620783
Registry record updated Mar 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
EndodonticsTaxonomy code 1223E0200X
License
DS044481 Issued in PA
Practice address
60 Parkwood Dr
Chambersburg, PA 17201-4501
Phone
(717) 262-0093
Fax
(717) 263-0051
NPI assigned
Feb 7, 2008
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endodontics 1223E0200X DS044481 PA Primary

Addresses

Primary practice location

60 Parkwood Dr
Chambersburg, PA 17201-4501

Mailing address

60 Parkwood Dr
Chambersburg, PA 17201-4501
Phone (717) 262-0093

Other practice location 1

8227 Old Courthouse Rd
#201
Vienna, VA 22182-3815
Phone (703) 883-3990

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS044481PAMDEndodontist

NPI Registry JSON

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

{
    "created_epoch": "1202342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711497600000",
    "number": "1366620783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "60 PARKWOOD DR",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172014501",
            "telephone_number": "717-262-0093",
            "fax_number": "717-263-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 PARKWOOD DR",
            "city": "CHAMBERSBURG",
            "state": "PA",
            "postal_code": "172014501",
            "telephone_number": "717-262-0093",
            "fax_number": "717-263-0051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8227 Old Courthouse Rd",
            "address_2": "#201",
            "address_purpose": "LOCATION",
            "city": "Vienna",
            "state": "VA",
            "postal_code": "221823815",
            "country_code": "US",
            "telephone_number": "703-883-3990",
            "fax_number": "703-883-3750",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GARY",
        "middle_name": "JOHN",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-02-07",
        "last_updated": "2024-03-27",
        "certification_date": "2024-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "PA",
            "license": "DS044481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chambersburg, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2024; 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.