Charles D. Johnson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Legal business name

CHARLES D. JOHNSON, DDS

Practice address

607 W Church St
Booneville, MS 38829-2647

Phone

(662) 728-8133

Fax

(662) 728-6903

NPI assigned

May 2, 2007

Last updated

Jul 21, 2022By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Joan Rorie

Title

Office Manager

Phone

(662) 728-8133

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Catherine Johnson Mincy, DDS

  • General Practice Dentistry
  • Booneville, MS
  • NPI 1679627335
  NPD (past)

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1629299847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 W CHURCH ST",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388292647",
            "telephone_number": "662-728-8133",
            "fax_number": "662-728-6903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "607 W CHURCH ST",
            "city": "BOONEVILLE",
            "state": "MS",
            "postal_code": "388292647",
            "telephone_number": "662-728-8133",
            "fax_number": "662-728-6903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES D. JOHNSON, DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-02",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "RORIE",
        "authorized_official_first_name": "JOAN",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "662-728-8133",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00004329",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Clifton C Cartwright, M.D.
• Clifton Wesley Cartwright, FNP-BC
• Pam Castle, PCMHT
• Catherine Johnson Mincy, DDS
• Elizabeth Caver
• David G Chase Sr., M.D.
• Meagan Cherry, NP
• Wendy Chisholm, CMHT
• CHR of Booneville, Inc. (Caring Hands Rehab)
• Desiree Patience Nicole Chupp

• General Practice Dentistry in Booneville, MS
• Providers in Booneville, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.