Winfield Clinton John III, DMD

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

4340 Issued in KY

Practice address

2301 Lexington Ave
Suite 120
Ashland, KY 41101-2873

Phone

(606) 329-2219

NPI assigned

Mar 20, 2008

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Jul 1, 2016 through Jul 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Oral & Maxillofacial Surgery PSC Inc

  • Oral and Maxillofacial Surgery Clinic/Center
  • Ashland, KY
  • NPI 1831292226
  NPD (past) Authorized official

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

{
    "created_epoch": "1205971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205971200000",
    "number": "1710158464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2301 LEXINGTON AVE",
            "address_2": "SUITE 120",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012873",
            "telephone_number": "606-329-2219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 LEXINGTON AVE",
            "address_2": "SUITE 120",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411012873",
            "telephone_number": "606-329-2219"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHN",
        "first_name": "WINFIELD",
        "middle_name": "CLINTON",
        "name_suffix": "III",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-03-20",
        "last_updated": "2008-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "KY",
            "license": "4340",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI GROUP #",
            "identifier": "1831292226",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROVIDER GROUP #",
            "identifier": "3465",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Taylor Jimison
• Elaine B. Jividen, ARNP
• Joel M Cost DDS PLLC
• Mary Johanson
• John W Morton, O.D.,P.S.C.
• Arianna Johnson
• Audrey Johnson
• Dana Allen Johnson, M.D.
• Edward L. Johnson, D.M.D.
• Emma Soleil Johnson, C/OTAL

• Oral and Maxillofacial Surgery (Dentist) in Ashland, KY
• Providers in Ashland, KY by specialty
• Oral and Maxillofacial Surgery (Dentist) in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.