Organization Active NPI

Richard E Johnson DDS

  • Dentist
  • Fresno, CA
National Provider Identifier
1851698740
Registry record updated Feb 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
22814 Issued in CA
Legal business name
RICHARD E JOHNSON DDS
Practice address
5646 N Palm Ave
Suite 101
Fresno, CA 93704-1848
Phone
(559) 431-6626
Fax
(559) 431-6499
NPI assigned
Feb 11, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2012

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

Authorized official

Name
Dr. Richard Evans Johnson, DDS
Title
Owner
Phone
(559) 431-6626

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 22814 CA Primary
Customized Equipment (DME) 332BC3200X 22814 CA

Addresses

Primary practice location

5646 N Palm Ave
Suite 101
Fresno, CA 93704-1848

Mailing address

2970 E Pryor Dr
Fresno, CA 93720-4498
Phone (559) 940-0876

National Provider Directory

National Provider Directory

Locations

5646 N Palm Ave
Ste 101
Fresno, CA 93704
Phone (559) 431-6626

Practitioners & affiliated clinicians

Practitioners 1

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": "1297382400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1329696000000",
    "number": "1851698740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2970 E PRYOR DR",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937204498",
            "telephone_number": "559-940-0876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5646 N PALM AVE",
            "address_2": "SUITE 101",
            "city": "FRESNO",
            "state": "CA",
            "postal_code": "937041848",
            "telephone_number": "559-431-6626",
            "fax_number": "559-431-6499"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RICHARD E JOHNSON DDS",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-02-11",
        "last_updated": "2012-02-20",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_middle_name": "EVANS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "559-431-6626",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "CA",
            "license": "22814",
            "primary": true
        },
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": "CA",
            "license": "22814",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fresno, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.