Jackie C Johns, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN9243 Issued in FL

Practice address

2100 45TH Street
- Suite a-8
West Palm Beach, FL 33407

Phone

(561) 842-5619

Fax

(561) 844-4085

NPI assigned

Apr 10, 2007

Sex

Male

Sole proprietor

Yes

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

Networks

• Freedom Health HMO Network

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.

• Esthetic & Implant Dentistry

  • Dental Clinic/Center
  • West Palm Beach, FL
  • NPI 1194992453
  NPD (past) Authorized official

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652227200000",
    "number": "1447473285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 45TH STREET",
            "address_2": "- SUITE A-8",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33407",
            "telephone_number": "561-842-5619",
            "fax_number": "561-844-4085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 45TH STREET",
            "address_2": "- SUITE A-8",
            "city": "WEST PALM BEACH",
            "state": "FL",
            "postal_code": "33407",
            "telephone_number": "561-842-5619",
            "fax_number": "561-844-4085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNS",
        "first_name": "JACKIE",
        "middle_name": "C",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-04-10",
        "last_updated": "2022-05-11",
        "certification_date": "2022-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN9243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John Boswell, MSW, LCSW, LLC.
• John C Whelton MD PA
• John H. Merey M.D., P.a.
• John R Jordan DMD PL
• Johnathan C Greenfield MD PA
• Burundi Johnson Chung
• Allison Johnson, DC
• Aneta Johnson
• Ann L Johnson, ARNP
• Brenda C Johnson, M.S. MHC

• General Practice Dentistry in West Palm Beach, FL
• Providers in West Palm Beach, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 11, 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.