Jeremy Leonard Johnson, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

DE00009214 Issued in WA

Practice address

14650 N Kelsey St # 104-105
Monroe, WA 98272-1456

Phone

(360) 794-8580

Fax

(844) 470-1798

NPI assigned

Aug 29, 2006

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

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Monroe Smiles Inc

  • General Practice Dentistry
  • Monroe, WA
  • NPI 1184154155
  NPD

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

{
    "created_epoch": "1156809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1376651364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14650 N KELSEY ST #104-105",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "98272",
            "telephone_number": "360-794-8580",
            "fax_number": "844-470-1798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14650 N KELSEY ST # 104-105",
            "city": "MONROE",
            "state": "WA",
            "postal_code": "982721456",
            "telephone_number": "360-794-8580",
            "fax_number": "844-470-1798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JEREMY",
        "middle_name": "LEONARD",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-29",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00009214",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Christine Jauregui
• Quinn Niomi Jay, CPSS
• Lisa Caroline John, ARNP
• Colleen Fay Johnson Sr., MS, LMHC, CMHS
• Jane T Johnson, SLP
• Sean L Johnson, LICSW
• Shannon Elizabeth Johnson, LMP
• Theresa Diane Johnson, BSN, RN
• Graham Christopher Jones, D.D.S., M.S.D.
• Joseph Szabo DDS PLLC

• Dentist in Monroe, WA
• Providers in Monroe, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.