Individual provider Active NPI

Christopher T Johnson, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Clermont, FL
National Provider Identifier
1467498253
Registry record updated Oct 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
DN14869 Issued in FL
Practice address
855 Oakley Seaver Dr
Clermont, FL 34711-1968
Phone
(352) 242-0627
Fax
(352) 242-0648
NPI assigned
Jun 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X DN14869 FL Primary

Addresses

Primary practice location

855 Oakley Seaver Dr
Clermont, FL 34711-1968

Mailing address

855 Oakley Seaver Dr
Clermont, FL 34711-1968
Phone (352) 242-0627

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040903000842 FL Practitioner - Oral SurgeryPractitioner - Maxillofacial Surgery 9638145386 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Oral SurgeryAlso: Maxillofacial Surgery
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

855 Oakley Seaver Dr
Clermont, FL 34711-1968
Phone (352) 242-0627

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Faces, LLC Oral and Maxillofacial Surgery CurrentSince Sep 27, 2006 Accepting new patients
Orofacial & Dental Implant Surgery Associates PA Oral and Maxillofacial Surgery PastSince Oct 1, 2003 Accepting new patients
Ed Blanton, DDS, PA Oral and Maxillofacial Surgery Past Accepting new patients

Locations

855 Oakley Seaver Dr
Clermont, FL 34711
Phone (352) 242-0627

1381 Citrus Tower Blvd
Ste 103
Clermont, FL 34711
Phone (352) 242-0627

2149 US Highway 441
Leesburg, FL 34748
Phone (352) 728-6600

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350518400000",
    "number": "1467498253",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "855 OAKLEY SEAVER DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111968",
            "telephone_number": "352-242-0627",
            "fax_number": "352-242-0648"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "855 OAKLEY SEAVER DR",
            "city": "CLERMONT",
            "state": "FL",
            "postal_code": "347111968",
            "telephone_number": "352-242-0627",
            "fax_number": "352-242-0648"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-21",
        "last_updated": "2012-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "DN14869",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clermont, FL

Sources for this page

Verify at the official NPI Registry.