Robert Carl Johnson Jr., DDS

Primary specialty

DentistTaxonomy code 122300000X

License

30-016433 Issued in OH

Practice address

7260 West Blvd
BLDG. G
Boardman, OH 44512-7334

Phone

(330) 758-8388

Fax

(330) 758-6733

NPI assigned

Sep 5, 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

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1188950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188950400000",
    "number": "1467646240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7260 WEST BLVD",
            "address_2": "BLDG. G",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445127334",
            "telephone_number": "330-758-8388",
            "fax_number": "330-758-6733"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7260 WEST BLVD",
            "address_2": "BLDG. G",
            "city": "BOARDMAN",
            "state": "OH",
            "postal_code": "445127334",
            "telephone_number": "330-758-8388",
            "fax_number": "330-758-6733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ROBERT",
        "middle_name": "CARL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-09-05",
        "last_updated": "2007-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30-016433",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• John a Esarco D.C. LTD
• John a Flauto DPM LLC
• John S Venglarcik III
• Amber Lee Johnson, LPN
• Kenneth D Johnson Jr., PT
• Jeffrey Thomas Johnston, M.D.
• Kimberly Robin Johnston, LPN
• Autumn R Jones, FNP
• Carmen Jones
• Hezekiah D Jones

• Dentist in Boardman, OH
• Providers in Boardman, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.