Mark a. Johnson DDS PS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

6095 Issued in WA

Legal business name

MARK A. JOHNSON DDS PS

Practice address

601 SE 117TH Ave Ste 200
Vancouver, WA 98683-5297

Phone

(360) 254-1590

Fax

(360) 254-1939

NPI assigned

Jun 3, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Mark A Johnson, DDS

Title

President

Phone

(360) 254-1590

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1243987200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1243987200000",
    "number": "1902032063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 SE 117TH AVE STE 200",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986835297",
            "telephone_number": "360-254-1590",
            "fax_number": "360-254-1939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 SE 117TH AVE STE 200",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986835297",
            "telephone_number": "360-254-1590",
            "fax_number": "360-254-1939"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK A. JOHNSON DDS PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-03",
        "last_updated": "2009-06-03",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "360-254-1590",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WA",
            "license": "6095",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthodontics and Dentofacial Orthopedics Dentistry in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2009; 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.