Paul Johnson, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

D-4745 Issued in ID

Practice address

1411 Falls Ave E Ste 1000C
Twin Falls, ID 83301-3459

Phone

(208) 734-7415

NPI assigned

Jul 18, 2012

Last updated

Oct 20, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1342569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476921600000",
    "number": "1871848598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1411 FALLS AVE E STE 1000C",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013459",
            "telephone_number": "208-734-7415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1411 FALLS AVE E STE 1000C",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833013459",
            "telephone_number": "208-734-7415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "PAUL",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-18",
        "last_updated": "2016-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "ID",
            "license": "D-4745",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60293839",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1023850",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jean Marie Johnson, M.S., CCC-SLP
• Kayla Lynne Johnson, RD
• Magdalen Johnson, RN, IBCLC
• Mayben Cole Johnson, DO
• Michael Scott Johnson, C.P.O
• Rhonda Michelle Johnson, LMSW
• Robert Max Johnson Jr., D.C.
• Samantha Wynn Johnson, NP
• Sara L Johnson, MD
• Sarah Johnson, AUD

• Dentist in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Dentist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; 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.