Paul W Johnson, D.M.D., PH.D.

Primary specialty

DentistTaxonomy code 122300000X

License

43798 Issued in CA

Practice address

8007 Laguna Blvd
Suite 1
Elk Grove, CA 95758-7920

Phone

(916) 691-6442

Fax

(916) 691-6452

NPI assigned

May 21, 2008

Last updated

May 21, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Fulbright Dental Group, PC

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1336384619
  Medicare reassignment NPD
• Paul W. Johnson,PH.D., D.M.D., Inc.

  • General Practice Dentistry
  • Elk Grove, CA
  • NPI 1154492239
  NPD (past) Authorized official
• Lumina Healthcare, LLC

  • General Practice Dentistry
  • Los Angeles, CA
  • NPI 1932343589
  NPD (past)

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

{
    "created_epoch": "1211328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1211328000000",
    "number": "1588821052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8007 LAGUNA BLVD",
            "address_2": "SUITE 1",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587920",
            "telephone_number": "916-691-6442",
            "fax_number": "916-691-6452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8007 LAGUNA BLVD",
            "address_2": "SUITE 1",
            "city": "ELK GROVE",
            "state": "CA",
            "postal_code": "957587920",
            "telephone_number": "916-691-6442",
            "fax_number": "916-691-6452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PAUL",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.M.D., PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-05-21",
        "last_updated": "2008-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "43798",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Keiessence Johnson
• Kimberly T Johnson, LCSW
• Marijhay Johnson
• Mersade Johnson
• Moneka Johnson
• Ramona Johnson
• Stephen Johnson
• Zion Johnson
• Mitchell Johnston, OT
• Andrella Vontella Jones-Thomas

• Dentist in Elk Grove, CA
• Providers in Elk Grove, CA by specialty
• Dentist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2008; 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.