Dwight Johnson

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2018021651 Issued in MO

Practice address

12200 15TH St Ste 106
Grandview, MO 64030-1772

Phone

(816) 398-8046

NPI assigned

Aug 14, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Raytown Dental

  • Dental Clinic/Center
  • Raytown, MO
  • NPI 1972267284
  NPD Authorized official
• Comfort Dental Grandview Aaron Parkin DMD PC

  • General Practice Dentistry
  • Grandview, MO
  • NPI 1558849414
  NPD (past)

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

{
    "created_epoch": "1534204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534204800000",
    "number": "1912487505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "701 E ARMOUR BLVD APT 506",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641092303",
            "telephone_number": "630-767-9740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12200 15TH ST STE 106",
            "city": "GRANDVIEW",
            "state": "MO",
            "postal_code": "640301772",
            "telephone_number": "816-398-8046"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DWIGHT",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-14",
        "last_updated": "2018-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2018021651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori Sherman Jeffries, FNP-C
• Job One Careers
• John a. Gillen II MD Orthopaedic Specialists P.a.
• Zachary Johns
• Aulois Zane Johnson, CCC, SLP
• Evette Johnson
• Jarvis Jones
• Mary L Judy, RPT
• Lama Kadourainieh
• Kansas City Health & Wellness Clinic, LLC

• General Practice Dentistry in Grandview, MO
• Providers in Grandview, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2018; 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.