Active NPI
Tara Maria Johnston, DDS
- Dentist
- Half Moon Bay, CA
National Provider Identifier
1548620107
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 100418
- Practice address
- 210 San Mateo Rd Ste 104
Half Moon Bay, CA 94019-7172 - Phone
- (650) 726-2144
- NPI assigned
- Feb 25, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 100418 | CA | Primary |
Addresses
Primary practice location
210 San Mateo Rd Ste 104
Half Moon Bay, CA 94019-7172
Mailing address
430 N El Camino Real
San Mateo, CA 94401-3710
Phone (650) 727-3480
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 100418 | CA | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sonrisas Dental Health, Inc | Past | Accepting new patients |
Interoperability endpoints
- tjohnston19737@smch.direct-ci.com
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 and National Provider Directory roles.
-
- General Practice Dentistry
- Half Moon Bay, CA
- NPI 1447477591
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1470096000000",
"number": "1548620107",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "430 N EL CAMINO REAL",
"city": "SAN MATEO",
"state": "CA",
"postal_code": "944013710",
"telephone_number": "650-727-3480"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "210 SAN MATEO RD STE 104",
"city": "HALF MOON BAY",
"state": "CA",
"postal_code": "940197172",
"telephone_number": "650-726-2144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTON",
"first_name": "TARA",
"middle_name": "MARIA",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-25",
"last_updated": "2016-08-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CA",
"license": "100418",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Half Moon Bay, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.