Organization Active NPI

Wendell S Johnson Dentistry Associates PA

  • General Practice Dentistry
  • Charleston, SC
National Provider Identifier
1669518809
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
1022SC Issued in SC
Legal business name
WENDELL S JOHNSON DENTISTRY ASSOCIATES PA
Practice address
915 St Andrews Blvd
Charleston, SC 29407
Phone
(843) 766-7880
Fax
(843) 766-6090
NPI assigned
Jan 29, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Wendell S Johnson, DDS
Title
Pres
Phone
(843) 766-7880

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 1022SC SC Primary

Addresses

Primary practice location

915 St Andrews Blvd
Charleston, SC 29407

Mailing address

915 St Andrews Blvd
Charleston, SC 29407
Phone (843) 766-7880

National Provider Directory

National Provider Directory

Locations

915 Saint Andrews Blvd
Charleston, SC 29407
Phone (843) 766-7880

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1170028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1669518809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 ST ANDREWS BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29407",
            "telephone_number": "843-766-7880",
            "fax_number": "843-766-6090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 ST ANDREWS BLVD",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "29407",
            "telephone_number": "843-766-7880",
            "fax_number": "843-766-6090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WENDELL S JOHNSON DENTISTRY ASSOCIATES PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-29",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "WENDELL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "843-766-7880",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "1022SC",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.