Jeffrey James Johnson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D12266 Issued in MN

Practice address

Fond Du Lac Human Services Division
927 Trettle Lane
Cloquet, MN 55720

Phone

(218) 879-1227

Fax

(218) 878-2188

NPI assigned

Jul 31, 2006

Last updated

Mar 7, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1760498778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 CHAMBERSBURG AVE",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558113203",
            "telephone_number": "218-269-1189"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "FOND DU LAC HUMAN SERVICES DIVISION",
            "address_2": "927 TRETTLE LANE",
            "city": "CLOQUET",
            "state": "MN",
            "postal_code": "55720",
            "telephone_number": "218-879-1227",
            "fax_number": "218-878-2188"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JEFFREY",
        "middle_name": "JAMES",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-31",
        "last_updated": "2023-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Independent School District 93 Carlton County
• Kijsa Irwin, RN AND CFCN
• Kathleen Ann Jarve, LGSW
• Jacqueline Marie Jennissen, ADC-T
• Margarita York Jesme, DNP, APRN, FNP-C
• Karen Marie Johnson, PT
• Kristy Johnson, LADC
• Rhonda J Johnson, PT
• Robert Alexander Johnson, DMD
• Timothy Johnson

• General Practice Dentistry in Cloquet, MN
• Providers in Cloquet, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.