NPIMap

Organization Active NPI

DRS Ebenezer & Rachel Johnson DDS Inc

  • Dentist
  • Rialto, CA
National Provider Identifier
1801085501
Registry record updated May 17, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
D36088 Issued in CA
Legal business name
DRS EBENEZER & RACHEL JOHNSON DDS INC
Practice address
511 S Riverside Ave
Rialto, CA 92376
Phone
(909) 820-2274
Fax
(909) 820-2280
NPI assigned
Oct 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Rachel R Johnson, D.D.SNPI 1366696262
Title
Dentist / Owner
Phone
(909) 920-5001

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X D36088 CA Primary

Addresses

Primary practice location

511 S Riverside Ave
Rialto, CA 92376

Mailing address

440 N. Mountain Dr
Suite 101
Upland, CA 91786
Phone (909) 920-5001

National Provider Directory

National Provider Directory
Tax ID family
DRS Ebenezer Rachel Johnson DDS Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

440 N Mountain Ave
Ste 101
Upland, CA 91786
Phone (909) 920-5001

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1621209600000",
    "number": "1801085501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "440 N. MOUNTAIN DR",
            "address_2": "SUITE 101",
            "city": "UPLAND",
            "state": "CA",
            "postal_code": "91786",
            "telephone_number": "909-920-5001",
            "fax_number": "909-980-5026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 S RIVERSIDE AVE",
            "city": "RIALTO",
            "state": "CA",
            "postal_code": "92376",
            "telephone_number": "909-820-2274",
            "fax_number": "909-820-2280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRS EBENEZER & RACHEL JOHNSON DDS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-18",
        "last_updated": "2021-05-17",
        "certification_date": "2021-05-17",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RACHEL",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "DENTIST / OWNER",
        "authorized_official_telephone_number": "909-920-5001",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "D36088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rialto, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2021; 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.