Jay Andrew Johnson, D.D.S.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

13757 Issued in FL

Practice address

96 Willard St
Suite 105
Cocoa, FL 32922-7991

Phone

(321) 631-7000

Fax

(321) 631-5135

NPI assigned

Jan 12, 2007

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 1, 2026 through Oct 1, 2028

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932259686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 WILLARD ST",
            "address_2": "SUITE 105",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329227991",
            "telephone_number": "321-631-7000",
            "fax_number": "321-631-5135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 WILLARD ST",
            "address_2": "SUITE 105",
            "city": "COCOA",
            "state": "FL",
            "postal_code": "329227991",
            "telephone_number": "321-631-7000",
            "fax_number": "321-631-5135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JAY",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "FL",
            "license": "13757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aimee R Jernick
• John G Carey MD PA
• Karena Johnson-Blackwell
• Delatron Johnson
• Gariesha L Johnson
• Stephanie Ann Chambers Johnson
• Tania Melissa Johnson, MSW
• Rhonda Jones-Davis, MA
• Marianne Jones, LCSW, RN
• Sharon A Jones, APRN

• Oral and Maxillofacial Surgery (Dentist) in Cocoa, FL
• Providers in Cocoa, FL by specialty
• Oral and Maxillofacial Surgery (Dentist) in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.