Stephen Johansen, D.D.S., PC

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

Practice address

7370 Creek Rd Ste 202
Sandy, UT 84093-6113

Phone

(801) 676-1234

Fax

(801) 676-5678

NPI assigned

Aug 23, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1187827200000",
    "number": "1861685752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7370 CREEK RD STE 202",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840936113",
            "telephone_number": "801-676-1234",
            "fax_number": "801-676-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7370 CREEK RD STE 202",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840936113",
            "telephone_number": "801-676-1234",
            "fax_number": "801-676-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANSEN",
        "first_name": "STEPHEN",
        "name_prefix": "Dr.",
        "credential": "D.D.S., PC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-08-23",
        "last_updated": "2007-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaleena Ann Jessop, D.D.S
• Louis Keith Jessop, D.D.S.
• Aleshia C Jex, CSW
• Jli LC
• JML Lab Solutions
• Troy Wilford Johansen, R.PH
• John a Dana MD PC
• John B. Krueger, MD, PC
• John Thueson, MD
• Barry Layle Johnson, DDS

• General Practice Dentistry in Sandy, UT
• Providers in Sandy, UT by specialty
• General Practice Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2007; 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.

Verify at the official NPI Registry.