NPIMap

Organization Active NPI

William R. Johnson, DMD

  • Pediatric Dentistry
  • Louisville, KY
National Provider Identifier
1831694314
Registry record updated Mar 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric DentistryTaxonomy code 1223P0221X
License
5700 Issued in KY
Legal business name
WILLIAM R. JOHNSON, DMD
Practice address
4007 Valley View Dr
Louisville, KY 40216-4221
Phone
(502) 448-0678
Fax
(502) 448-6292
NPI assigned
Mar 27, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2018

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

Authorized official

Name
Mrs. Elaine A Johnson
Title
Office Manager/Spouse
Phone
(502) 448-0678

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223G0001X 9805 KY
Pediatric DentistryGroup: 193200000X MULTI-SPECIALTY GROUP 1223P0221X 5700 KY Primary

Addresses

Primary practice location

4007 Valley View Dr
Louisville, KY 40216-4221

Mailing address

4007 Valley View Dr
Louisville, KY 40216-4221
Phone (502) 448-0678

Other identifiers 2

IdentifierTypeStateIssuer
7100484350MedicaidKY
60057007MedicaidKY

National Provider Directory

National Provider Directory

Locations

4007 Valley View Dr
Louisville, KY 40216
Phone (502) 448-0678

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1522108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522108800000",
    "number": "1831694314",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4007 VALLEY VIEW DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402164221",
            "telephone_number": "502-448-0678",
            "fax_number": "502-448-6292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4007 VALLEY VIEW DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402164221",
            "telephone_number": "502-448-0678",
            "fax_number": "502-448-6292"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIAM R. JOHNSON, DMD",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-27",
        "last_updated": "2018-03-27",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ELAINE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OFFICE MANAGER/SPOUSE",
        "authorized_official_telephone_number": "502-448-0678",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "KY",
            "license": "9805",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "KY",
            "license": "5700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100484350",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "60057007",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2018; 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.