Eddie Prince Johnson III, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

9685 Issued in GA

Practice address

27 5 5 Barton Chapel Road
Augusta, GA 30906-9579

Phone

(706) 790-9179

NPI assigned

Mar 26, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320883200000",
    "number": "1386762987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3400 HEATHER DR",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309092795",
            "telephone_number": "707-736-5421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27 5 5 BARTON CHAPEL ROAD",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309069579",
            "telephone_number": "706-790-9179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "EDDIE",
        "middle_name": "PRINCE",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-26",
        "last_updated": "2011-11-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "9685",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00254526C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney Johnson
• Craig Reid Johnson, D.O.
• Debbie Ruth Johnson, M.ED., LPC
• Diana Aranda Johnson, M.D.
• Douglas Johnson, MD
• Emily Anne Johnson, RD
• Eric H. Johnson, PTA
• Ifeoluwa Johnson
• Isabella D Johnson, RBT
• Jamie Lake Johnson, PHARMD

• Dentist in Augusta, GA
• Providers in Augusta, GA by specialty
• Dentist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2011; 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.