NPIMap

Organization Active NPI

Edwards, Johnson & Johnson

  • General Practice Dentistry
  • Renton, WA
National Provider Identifier
1417477019
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DE60204550 Issued in WA
Legal business name
EDWARDS, JOHNSON & JOHNSON
Practice address
1900 S Puget Dr
Renton, WA 98055-4421
Phone
(425) 228-1521
NPI assigned
Jun 23, 2017
Organization subpart
Yes
Parent organization
EDWARDS & JOHNSON D.D.S., P.L.L.C.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Authorized official

Name
Dr. Ben Johnson
Title
Partner
Phone
(425) 277-1844

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X WA
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X DE60204550 WA Primary

Addresses

Primary practice location

1900 S Puget Dr
Renton, WA 98055-4421

Mailing address

1900 S Puget Dr
Renton, WA 98055-4421
Phone (425) 228-1521

Other names 2

  • ELEVATE FAMILY DENTISTRY Doing business as
  • PACIFIC NORTHWEST ORAL & MAXILLOFACIAL SURGEONS Doing business as

National Provider Directory

National Provider Directory

Locations

1900 S Puget Dr
Renton, WA 98055
Phone (425) 228-1521

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1498176000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1417477019",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 S PUGET DR",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980554421",
            "telephone_number": "425-228-1521"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 S PUGET DR",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980554421",
            "telephone_number": "425-228-1521"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EDWARDS, JOHNSON & JOHNSON",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "EDWARDS & JOHNSON D.D.S., P.L.L.C.",
        "enumeration_date": "2017-06-23",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BEN",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "425-277-1844",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE60204550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ELEVATE FAMILY DENTISTRY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "PACIFIC NORTHWEST ORAL & MAXILLOFACIAL SURGEONS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Renton, WA

Sources for this page

  • 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.