Individual provider Active NPI

Jonathan Paul Johnson, D.M.D.

  • General Practice Dentistry
  • Hinesville, GA
National Provider Identifier
1821389644
Registry record updated Jun 19, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN014324 Issued in GA
Practice address
615 W Oglethorpe Hwy
Hinesville, GA 31313-4485
Phone
(912) 877-3070
NPI assigned
Apr 27, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 19, 2013

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X GA
General Practice Dentistry 1223G0001X DN014324 GA Primary

Addresses

Primary practice location

615 W Oglethorpe Hwy
Hinesville, GA 31313-4485

Mailing address

615 W Oglethorpe Hwy
Hinesville, GA 31313-4485
Phone (912) 877-3070

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
DN014324GAMDGeneral Practice Dentistry

NPI Registry JSON

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

{
    "created_epoch": "1303862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371600000000",
    "number": "1821389644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 W OGLETHORPE HWY",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134485",
            "telephone_number": "912-877-3070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 W OGLETHORPE HWY",
            "city": "HINESVILLE",
            "state": "GA",
            "postal_code": "313134485",
            "telephone_number": "912-877-3070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JONATHAN",
        "middle_name": "PAUL",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-04-27",
        "last_updated": "2013-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "GA",
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN014324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hinesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2013; 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.