Dr. Warren Johnson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

7748 Issued in MN

Legal business name

DR. WARREN JOHNSON, DDS

Practice address

422 Heritage Place
Faribault, MN 55021

Phone

(507) 334-5602

Fax

(507) 334-3488

NPI assigned

Apr 24, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Warren D Johnson, DDS

Title

Owner/Practice

Phone

(507) 334-5602

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1240531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1240531200000",
    "number": "1568606283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "422 HERITAGE PLACE",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "55021",
            "telephone_number": "507-334-5602",
            "fax_number": "507-334-3488"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "422 HERITAGE PLACE",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "55021",
            "telephone_number": "507-334-5602",
            "fax_number": "507-334-3488"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. WARREN JOHNSON, DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-24",
        "last_updated": "2009-04-24",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "WARREN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER/PRACTICE",
        "authorized_official_telephone_number": "507-334-5602",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "MN",
            "license": "7748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "950017100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.