Individual provider Active NPI

Molly Johnson, DMD

  • Dentist
  • Pinole, CA
National Provider Identifier
1518529080
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
103929 Issued in CA
Practice address
2000 Appian Way Ste 201
Pinole, CA 94564-2525
Phone
(925) 510-8555
NPI assigned
Jul 3, 2019
Last updated
Jun 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 103929 CA Primary

Addresses

Primary practice location

2000 Appian Way Ste 201
Pinole, CA 94564-2525

Mailing address

331 Liveoak CT
Martinez, CA 94553-3573
Phone (925) 330-9352

Other practice location 1

1 Santa Maria Way
Orinda, CA 94563-2604
Phone (925) 254-5100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20191113002159 CA Order and Referring Only - DentistPractitioner - Dentist 4587096516

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
103929CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Amardeep Gill, D.D.S., Inc. Dentist Past Accepting new patients
Pacific Dental Services Dentist Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1562112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1518529080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 LIVEOAK CT",
            "city": "MARTINEZ",
            "state": "CA",
            "postal_code": "945533573",
            "telephone_number": "925-330-9352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 APPIAN WAY STE 201",
            "city": "PINOLE",
            "state": "CA",
            "postal_code": "945642525",
            "telephone_number": "925-510-8555"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Santa Maria Way",
            "address_purpose": "LOCATION",
            "city": "Orinda",
            "state": "CA",
            "postal_code": "945632604",
            "country_code": "US",
            "telephone_number": "925-254-5100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MOLLY",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-03",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "103929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pinole, CA

Sources for this page

Verify at the official NPI Registry.