Active NPI
Zelton G Johnson, DDS
- Dentist
- Flint, MI
National Provider Identifier
1386757391
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 10685
- Practice address
- 4170 Lennon Rd
Ste B
Flint, MI 48507 - Phone
- (810) 720-0701
- Fax
- (810) 720-0703
- NPI assigned
- Aug 16, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 10685 | MI | Primary |
Addresses
Primary practice location
4170 Lennon Rd
Ste B
Flint, MI 48507
Mailing address
4170 Lennon Rd
Ste B
Flint, MI 48507
Phone (810) 720-0701
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150511000017 | MI | Order and Referring Only - Other (Non-Physician) | 1557680709 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10685 | MI | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Zelton G Johnson DDS | Current | Accepting new patients |
Locations
4170 Lennon Rd
Ste B
Flint, MI 48507
Phone (810) 720-0701
Organizations & group practices 1
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.
-
- Dental Clinic/Center
- Flint, MI
- NPI 1962122515
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155686400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1661990400000",
"number": "1386757391",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4170 LENNON RD",
"address_2": "STE B",
"city": "FLINT",
"state": "MI",
"postal_code": "48507",
"telephone_number": "810-720-0701",
"fax_number": "810-720-0703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4170 LENNON RD",
"address_2": "STE B",
"city": "FLINT",
"state": "MI",
"postal_code": "48507",
"telephone_number": "810-720-0701",
"fax_number": "810-720-0703"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "ZELTON",
"middle_name": "G",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-16",
"last_updated": "2022-09-01",
"certification_date": "2022-09-01",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MI",
"license": "10685",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Flint, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.