Active NPI
Michael Corey Johnson, DDS
- Dentist
- Mountain Lakes, NJ
National Provider Identifier
1851439392
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 15749
- Practice address
- 115 US Highway 46
B 15
Mountain Lakes, NJ 07046-1668 - Phone
- (973) 402-8111
- NPI assigned
- Feb 4, 2007
- Sex
- Male
- 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 | 15749 | NJ | Primary |
Addresses
Primary practice location
115 US Highway 46
B 15
Mountain Lakes, NJ 07046-1668
Mailing address
5 Cold Hill Rd. South
8
Mendham, NJ 07945
Phone (973) 543-4828
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NJ
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: No
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170502002043 | NJ | Order and Referring Only - Dentist | 0345527255 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15749 | NJ | MD | Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170547200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1493683200000",
"number": "1851439392",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5 COLD HILL RD. SOUTH",
"address_2": "8",
"city": "MENDHAM",
"state": "NJ",
"postal_code": "07945",
"telephone_number": "973-543-4828"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 US HIGHWAY 46",
"address_2": "B 15",
"city": "MOUNTAIN LAKES",
"state": "NJ",
"postal_code": "070461668",
"telephone_number": "973-402-8111"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "MICHAEL",
"middle_name": "COREY",
"name_prefix": "Dr.",
"credential": "DDS",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-04",
"last_updated": "2017-05-02",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "NJ",
"license": "15749",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountain Lakes, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 2, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.