Mark Robin Johnson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DN013620 Issued in GA

Practice address

114 Altama Connector
Brunswick, GA 31525-1891

Phone

(912) 262-6688

Fax

(912) 264-2409

NPI assigned

Dec 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Morrison Dental Associates, P.C.

  • Dentist
  • Brunswick, GA
  • NPI 1427285600
  NPD (past)

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1354060800000",
    "number": "1831251867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 ALTAMA CONNECTOR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "31535",
            "telephone_number": "912-262-6688",
            "fax_number": "912-264-2409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 ALTAMA CONNECTOR",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315251891",
            "telephone_number": "912-262-6688",
            "fax_number": "912-264-2409"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARK",
        "middle_name": "ROBIN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2012-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12008101",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "GA",
            "license": "DN013620",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "GA",
            "license": "DN013620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "422264878",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deborah F Johnson, RN-BSN
• Evelyn Delois Johnson, M.D.
• Jimmy Wallace Johnson Jr.
• Laura Johnson, PA-C
• Mallory Harris Johnson, CRNA
• Steven G Johnson, M.D.
• Tawana Johnson, RN
• William R Johnson, PH.D.
• Matthew M Johnston, M.D.
• Kimberly S. Joiner, AU.D.

• General Practice Dentistry in Brunswick, GA
• Providers in Brunswick, GA by specialty
• General Practice Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2012; 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.