Samuel Eric Johnson, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3996-18 Issued in MS

Practice address

112 Lamar Blvd
Hattiesburg, MS 39402-8147

Phone

(601) 450-5550

NPI assigned

Jun 5, 2018

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

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.

• Cronin Family Dentistry PA

  • General Practice Dentistry
  • Hattiesburg, MS
  • NPI 1902120199
  NPD (past)

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

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1780176677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 LAMAR BLVD",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028147",
            "telephone_number": "601-450-5550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 LAMAR BLVD",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028147",
            "telephone_number": "601-450-5550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SAMUEL",
        "middle_name": "ERIC",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-05",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "3996-18",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eva Johnson, RN
• Jeffrey A Johnson, MD
• John Alden Johnson III, M.D.
• John J Johnson, MD
• Karen Trenice Johnson, PHARMD
• Shanon Hodges Johnson, SLP
• Skylarr Johnson, PCCSS
• Tatum Mayfield Johnson
• Tina Johnson, LCSW
• Wesley Johnson, DNP, CRNA

• General Practice Dentistry in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2024; 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.