Individual provider Active NPI

Christian Edgar Johnson Jr.

  • General Practice Dentistry
  • Warwick, RI
National Provider Identifier
1548230261
Registry record updated Feb 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
2608 Issued in RI
Practice address
3274 W Shore Rd
Warwick, RI 02886-7560
Phone
(401) 739-1399
NPI assigned
Jan 25, 2006
Last updated
Feb 6, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 6, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2608 RI Primary

Addresses

Primary practice location

3274 W Shore Rd
Warwick, RI 02886-7560

Mailing address

3274 W Shore Rd
Warwick, RI 02886-7560
Phone (401) 739-1399

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI
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
I20160614001787 RI Order and Referring Only - DentistPractitioner - Dentist 0244521706

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2608RIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Robert a Conte D.M.D. Inc. Past Accepting new patients

Organizations & group practices 1

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": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1360108800000",
    "number": "1548230261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3274 W SHORE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028867560",
            "telephone_number": "401-739-1399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3274 W SHORE RD",
            "city": "WARWICK",
            "state": "RI",
            "postal_code": "028867560",
            "telephone_number": "401-739-1399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHRISTIAN",
        "middle_name": "EDGAR",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2013-02-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "RI",
            "license": "2608",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warwick, RI

Sources for this page

Verify at the official NPI Registry.