Vip Smiles Johnson Dental Inc

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

30-21917 Issued in OH

Legal business name

VIP SMILES JOHNSON DENTAL INC

Doing business as

VIP SMILES

Practice address

5260 Warrensville Ctr Rd
Maple Heights, OH 44137-1913

Phone

(216) 475-0080

Fax

(216) 475-0778

NPI assigned

Oct 27, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Lucia Johnson, D.M.D.

Title

Chairman

Phone

(216) 288-7560

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• VIP SMILES Doing business as

Locations

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

{
    "created_epoch": "1256601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1256601600000",
    "number": "1497081459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5260 WARRENSVILLE CTR RD",
            "city": "MAPLE HEIGHTS",
            "state": "OH",
            "postal_code": "441371913",
            "telephone_number": "216-475-0080",
            "fax_number": "216-475-0778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5260 WARRENSVILLE CTR RD",
            "city": "MAPLE HEIGHTS",
            "state": "OH",
            "postal_code": "441371913",
            "telephone_number": "216-475-0080",
            "fax_number": "216-475-0778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VIP SMILES JOHNSON DENTAL INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-10-27",
        "last_updated": "2009-10-27",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "LUCIA",
        "authorized_official_title_or_position": "CHAIRMAN",
        "authorized_official_telephone_number": "216-288-7560",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.M.D."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "OH",
            "license": "30-21917",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2492440",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VIP SMILES",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• General Practice Dentistry in Maple Heights, OH
• Providers in Maple Heights, OH by specialty
• General Practice Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2009; 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.