Johnson, Dixson & Pond Dentistry

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00009942 Issued in WA

Legal business name

JOHNSON, DIXSON & POND DENTISTRY

Doing business as

Smiles Family Dental

Practice address

820 Ocean Beach Hwy,
Ste 110
Longview, WA 98632-4011

Phone

(360) 577-0566

Fax

(360) 425-6935

NPI assigned

Mar 28, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Jeromy R. Dixson, DMD

Title

Partner

Phone

(360) 577-0566

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Smiles Family Dental Doing business as

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

{
    "created_epoch": "1175040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268870400000",
    "number": "1912026063",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 OCEAN BEACH HWY",
            "address_2": "STE 110",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986324080",
            "telephone_number": "360-577-0566",
            "fax_number": "360-425-6935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "820 OCEAN BEACH HWY,",
            "address_2": "STE 110",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986324011",
            "telephone_number": "360-577-0566",
            "fax_number": "360-425-6935"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JOHNSON, DIXSON & POND DENTISTRY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-28",
        "last_updated": "2010-03-18",
        "status": "A",
        "authorized_official_last_name": "DIXSON",
        "authorized_official_first_name": "JEROMY",
        "authorized_official_middle_name": "R.",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "360-577-0566",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00008175",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00009942",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5046164",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI- PERSONAL",
            "identifier": "1205926110",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Smiles Family Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Donna Marie Jessen, RDH
• Cynthia Jewett, BACHELORS
• June Li Jia, M.D. PH.D.
• John Berwind DDS PS
• Corey S Johnson, M.D.
• Jan Gary Johnson, PH.D.
• Kala Johnson
• Katie Johnson, MS, ARNP, ACNS-BC
• Kelly Johnson
• Lashaun D Johnson, R-ACC

• General Practice Dentistry in Longview, WA
• Providers in Longview, WA by specialty
• General Practice Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2010; 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.