Joseph G Johansen DDS PC

Primary specialty

Oral and Maxillofacial Surgery Clinic/CenterTaxonomy code 261QS0112X

License

AZ3185 Issued in AZ

Legal business name

JOSEPH G JOHANSEN DDS PC

Practice address

3048 E Baseline Rd
Suite #105
Mesa, AZ 85204-7286

Phone

(480) 632-8848

NPI assigned

Nov 2, 2007

Organization subpart

No

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

Authorized official

Name

Joseph Grant Johansen, DDS

Title

Oral Maxillofacial Surgeon

Phone

(480) 632-1508

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193961600000",
    "number": "1649459926",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3048 E BASELINE RD",
            "address_2": "SUITE #105",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852047286",
            "telephone_number": "480-632-8848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3048 E BASELINE RD",
            "address_2": "SUITE #105",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852047286",
            "telephone_number": "480-632-8848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOSEPH G JOHANSEN DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-02",
        "last_updated": "2007-11-02",
        "status": "A",
        "authorized_official_last_name": "JOHANSEN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_middle_name": "GRANT",
        "authorized_official_title_or_position": "ORAL MAXILLOFACIAL SURGEON",
        "authorized_official_telephone_number": "480-632-1508",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QS0112X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Oral and Maxillofacial Surgery",
            "state": "AZ",
            "license": "AZ3185",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Alfred Jordan, PHARMD
• Vanessa Lee Jordan
• Chad C Jorgensen, MD
• Josh Jorgensen
• Todd F Jorgenson, D.M.D., M.S.
• Joseph G. Abdo, M.D., P.C.
• Mireille Joseph Jerome, MD- PA
• Joseph L. Chatham, M.D. LTD
• Joseph R Gottesman, LLC
• Kathiana Marie Joseph

• Oral and Maxillofacial Surgery Clinic/Center in Mesa, AZ
• Providers in Mesa, AZ by specialty
• Oral and Maxillofacial Surgery Clinic/Center in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2007; 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.