Active NPI
Kevin Craig Johnstun, D.M.D.
- Dentist
- El Paso, TX
National Provider Identifier
1902113616
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 26043
- Practice address
- 1502 N Zaragoza Rd
El Paso, TX 79936-7905 - Phone
- (915) 855-4442
- NPI assigned
- Sep 2, 2010
- Last updated
- Dec 10, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 7433155-9922 | UT | |
| Dentist | 122300000X | 26043 | TX | Primary |
Addresses
Primary practice location
1502 N Zaragoza Rd
El Paso, TX 79936-7905
Mailing address
8151 E Indian Bend Rd
Suite 111
Scottsdale, AZ 85250-4826
Phone (480) 607-9999
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26043 | TX | MD | Dentist |
| 7433155-9922 | UT | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| E. P. Dentistry 4 Kids 1, PLLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba E.P. Dentistry 4 Kids
- General Practice Dentistry
- El Paso, TX
- NPI 1184879579
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1283385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449705600000",
"number": "1902113616",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8151 E INDIAN BEND RD",
"address_2": "SUITE 111",
"city": "SCOTTSDALE",
"state": "AZ",
"postal_code": "852504826",
"telephone_number": "480-607-9999"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1502 N ZARAGOZA RD",
"city": "EL PASO",
"state": "TX",
"postal_code": "799367905",
"telephone_number": "915-855-4442"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSTUN",
"first_name": "KEVIN",
"middle_name": "CRAIG",
"credential": "D.M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-09-02",
"last_updated": "2015-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "UT",
"license": "7433155-9922",
"primary": false
},
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "26043",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in El Paso, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.