Joseph Wong Johnson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

D13080 Issued in MN

Practice address

8417 W 101St Street Cir
Bloomington, MN 55438-1914

Phone

(612) 387-2277

NPI assigned

Apr 18, 2012

Last updated

May 24, 2012By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1334707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337817600000",
    "number": "1790042539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8417 W 101ST STREET CIR",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554381914",
            "telephone_number": "612-387-2277"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8417 W 101ST STREET CIR",
            "city": "BLOOMINGTON",
            "state": "MN",
            "postal_code": "554381914",
            "telephone_number": "612-387-2277"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JOSEPH",
        "middle_name": "WONG",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-18",
        "last_updated": "2012-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D13080",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Ruth Johnson, RN
• Emma Johnson
• Esther Joy Johnson
• Gretchen S Johnson, MA
• Jeanne Adelaide Johnson, LADC, BA, ICADC, LAC
• Katelyn Johnson
• Kenneth James Johnson, R.PH.
• Kiara Shante' Johnson I
• Lily Rose Johnson
• Marie Elizabeth Johnson

• Dentist in Bloomington, MN
• Providers in Bloomington, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2012; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.