Phillip S Johnson, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

9613 Issued in CO

Practice address

6979 S Holly Cir Ste 225
Centennial
Centennial, CO 80112-1065

Phone

(303) 779-1305

NPI assigned

Dec 14, 2005

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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 CO

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

Practice roles

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.

• SJ Dental PC

  • Dentist
  • Centennial, CO
  • NPI 1285905810
  NPD (past)

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

{
    "created_epoch": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1558346270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6979 S HOLLY CIR STE 225",
            "address_2": "CENTENNIAL",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801121065",
            "telephone_number": "303-779-1305"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6979 S HOLLY CIR STE 225",
            "address_2": "CENTENNIAL",
            "city": "CENTENNIAL",
            "state": "CO",
            "postal_code": "801121065",
            "telephone_number": "303-779-1305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PHILLIP",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "9613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristie Johnson, D.P.T.
• Lauren Elizabeth Johnson, AU.D.
• Maria S Johnson, D.M.D
• Matthew Johnson, LMFT
• Maylene April Johnson, M.A.
• Robert J. Johnson, SAP, MAC, LAC
• Roberta Michelle Johnson, D.C.
• Shannon Christina Johnson, PA-C
• Susan Johnson
• Douglas Leslie Johnston, D.D.S.

• Dentist in Centennial, CO
• Providers in Centennial, CO by specialty
• Dentist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.