Individual provider Active NPI

Jayme Jo Johnson, DMD

  • Public Health Dentistry
  • Goleta, CA
National Provider Identifier
1801336433
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health DentistryTaxonomy code 1223D0001X
License
D14011 Issued in MN
Practice address
164 Kinman Ave
Goleta, CA 93117-3481
Phone
(805) 617-7898
Fax
(805) 617-7899
NPI assigned
Mar 1, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health Dentistry 1223D0001X D14011 MN Primary

Addresses

Primary practice location

164 Kinman Ave
Goleta, CA 93117-3481

Mailing address

414 E Cota St FL 1
Santa Barbara, CA 93101-1624
Phone (805) 617-7898

Other names 1

  • Jayme Jo Noeske Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
D14011MNMDPublic Health Dentist

Interoperability endpoints

  • Direct secure messaging: jnoeske236777@direct.ochin.org

NPI Registry JSON

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

{
    "created_epoch": "1488326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1801336433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 E COTA ST FL 1",
            "city": "SANTA BARBARA",
            "state": "CA",
            "postal_code": "931011624",
            "telephone_number": "805-617-7898",
            "fax_number": "805-617-7899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "164 KINMAN AVE",
            "city": "GOLETA",
            "state": "CA",
            "postal_code": "931173481",
            "telephone_number": "805-617-7898",
            "fax_number": "805-617-7899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JAYME",
        "middle_name": "JO",
        "credential": "DMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-03-01",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223D0001X",
            "taxonomy_group": "",
            "desc": "Dentist, Dental Public Health",
            "state": "MN",
            "license": "D14011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JAYME",
            "last_name": "NOESKE",
            "middle_name": "JO",
            "credential": "DMD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Goleta, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.