Active NPI
Lori D Johnson, DDS
- Dentist
- Belzoni, MS
National Provider Identifier
1821352667
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 3710-13
- Practice address
- 127 N Hayden St
Belzoni, MS 39038-3931 - Phone
- (662) 318-5050
- NPI assigned
- Jun 26, 2012
- Last updated
- Sep 16, 2015
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 3710-13 | MS | Primary |
Addresses
Primary practice location
127 N Hayden St
Belzoni, MS 39038-3931
Mailing address
PO Box 68844
Jackson, MS 39286-8844
Phone (601) 665-0013
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 03637810 | Medicaid | MS |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 3710-13 | MS | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1340668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1442361600000",
"number": "1821352667",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 68844",
"city": "JACKSON",
"state": "MS",
"postal_code": "392868844",
"telephone_number": "601-665-0013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "127 N HAYDEN ST",
"city": "BELZONI",
"state": "MS",
"postal_code": "390383931",
"telephone_number": "662-318-5050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "LORI",
"middle_name": "D",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-06-26",
"last_updated": "2015-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "MS",
"license": "3710-13",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "03637810",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}Other providers in Belzoni, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.