Kyle Robert Johnson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

13423554-9921 Issued in UT

Practice address

620 John Paul Jones Cir
Portsmouth, VA 23708-2111

Phone

(843) 230-1246

NPI assigned

Jun 2, 2023

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

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

{
    "created_epoch": "1685664000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1685664000000",
    "number": "1811680952",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2402 WHALER CT",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234511225",
            "telephone_number": "843-230-1246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 JOHN PAUL JONES CIR",
            "city": "PORTSMOUTH",
            "state": "VA",
            "postal_code": "237082111",
            "telephone_number": "843-230-1246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KYLE",
        "middle_name": "ROBERT",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-02",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "UT",
            "license": "13423554-9921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joshua Heath Johnson, M.D.
• Judy Delois Johnson
• Kimberly Johnson, R.N.
• Kimberly Renee Johnson, EP
• Kristi Johnson, M.S., CCC-SLP
• Lisa Maria Johnson, PHARMD
• Mark Stephen Johnson, MD
• Rebecca Lynn Johnson, M.D.
• Shawn Johnson, DO
• Susan Deana Johnson, DDS

• Dentist in Portsmouth, VA
• Providers in Portsmouth, VA by specialty
• Dentist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; 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.