Jon Kelly Johnson, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7057 Issued in KY

Practice address

100 E High St
Mt Sterling, KY 40353-1214

Phone

(859) 498-7130

Fax

(859) 498-7138

NPI assigned

Sep 26, 2011

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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Sterling Family Dental Care, LLC

  • General Practice Dentistry
  • Mt Sterling, KY
  • NPI 1720133879
  NPD (past) Authorized official
• Dental Health Professionals of Kentucky, P.S.C.

  • General Practice Dentistry
  • Mount Sterling, KY
  • NPI 1295346476
  NPD (past)

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

{
    "created_epoch": "1316995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316995200000",
    "number": "1760765770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 E HIGH ST",
            "city": "MT STERLING",
            "state": "KY",
            "postal_code": "403531214",
            "telephone_number": "859-498-7130",
            "fax_number": "859-498-7138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 E HIGH ST",
            "city": "MT STERLING",
            "state": "KY",
            "postal_code": "403531214",
            "telephone_number": "859-498-7130",
            "fax_number": "859-498-7138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JON",
        "middle_name": "KELLY",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-09-26",
        "last_updated": "2011-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "7057",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60070570",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vivian Jeffries
• Kristeena Jenkins
• John I Gray III PSC
• Anne Marie Johnson
• Ashley Elizabeth Johnson, APRN
• Kennetha Doreen Johnson, RN
• Margaret B Johnson, LPCC
• Monica Lynn Johnson, APRN
• Tiara Johnson
• Carol Jones

• General Practice Dentistry in Mt Sterling, KY
• Providers in Mt Sterling, KY by specialty
• General Practice Dentistry in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2011; 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.