Dr. James K. Johnson Jr.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

4955 Issued in MD

Legal business name

DR. JAMES K. JOHNSON JR.

Practice address

5813 Moravia Rd
Baltimore, MD 21206-6133

Phone

(410) 488-8471

Fax

(410) 488-1115

NPI assigned

Jun 23, 2008

Organization subpart

No

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

Authorized official

Name

Dr. James Kenneth Johnson Jr., D.D.S

Title

Owner

Phone

(410) 488-8471

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1214179200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1871754770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5813 MORAVIA RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212066133",
            "telephone_number": "410-488-8471",
            "fax_number": "410-488-1115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5813 MORAVIA RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212066133",
            "telephone_number": "410-488-8471",
            "fax_number": "410-488-1115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. JAMES K. JOHNSON JR.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-23",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "KENNETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "410-488-8471",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "D.D.S"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, General Practice",
            "state": "MD",
            "license": "4955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "071634100",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.