Scarlett La'Ree Johnson, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4129-20 Issued in MS

Practice address

155 Millhouse Dr
Madison, MS 39110-6964

Phone

(415) 235-8811

NPI assigned

Jun 2, 2020

Last updated

Jul 2, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Bay Breeze Dental Group

  • Dental Clinic/Center
  • Gulfport, MS
  • NPI 1619846656
  NPD Authorized official

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

{
    "created_epoch": "1591056000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1593648000000",
    "number": "1831713213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 MILLHOUSE DR",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391106964",
            "telephone_number": "415-235-8811"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 MILLHOUSE DR",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391106964",
            "telephone_number": "415-235-8811"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "SCARLETT",
        "middle_name": "LA'REE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-02",
        "last_updated": "2020-07-02",
        "certification_date": "2020-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "4129-20",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wayne P Jimenez, PT
• Amanda G Johnson, PHARMD
• Katherine Johnson, PLPC, NCC
• Nathan Dale Johnson, DO
• Sarah Hampton Johnson, OT
• Shakyla Johnson
• Deven Spell Johnston, PHARM.D.
• Lewis Dubard Johnston, M.D.
• Melanie Jeannine Johnston, COTA/L
• Jones Chiropractic Clinic

• General Practice Dentistry in Madison, MS
• Providers in Madison, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2020; 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.