Active NPI
Keandra Stewart-Johnson
- Dentist
- Silver Spring, MD
National Provider Identifier
1417709239
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 1234
- Practice address
- 1400 E West Hwy Ste G
Silver Spring, MD 20910-3230 - Phone
- (301) 585-6804
- NPI assigned
- Apr 4, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 | 1234 | GA | Primary |
Addresses
Primary practice location
1400 E West Hwy Ste G
Silver Spring, MD 20910-3230
Mailing address
1400 E West Hwy Ste G
Silver Spring, MD 20910-3230
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1234 | GA | MD | Student in an Organized Health Care Education/Training Program |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712188800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1774396800000",
"number": "1417709239",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 E WEST HWY STE G",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209103230"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 E WEST HWY STE G",
"city": "SILVER SPRING",
"state": "MD",
"postal_code": "209103230",
"telephone_number": "301-585-6804"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART-JOHNSON",
"first_name": "KEANDRA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-04-04",
"last_updated": "2026-03-25",
"certification_date": "2026-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "GA",
"license": "1234",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Silver Spring, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.