Jeff O Johnson, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

3324 Issued in SC

Practice address

16 Mills Ave Ste 4
Greenville, SC 29605-4065

Phone

(864) 271-3463

Fax

(864) 271-9514

NPI assigned

Jan 3, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in SC

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1167782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932266145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 MILLS AVE STE 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054065",
            "telephone_number": "864-271-3463",
            "fax_number": "864-271-9514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 MILLS AVE STE 4",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054065",
            "telephone_number": "864-271-3463",
            "fax_number": "864-271-9514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JEFF",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "SC",
            "license": "3324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "ZX3324",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Houston Johnson
• Jake Carson Johnson, MD
• James Johnson, MS
• James Gowen Johnson IV, MD
• Jamila Johnson
• Jill Johnson, CRNA
• Joel Alexander Johnson, CRNA
• Joel Daniel Johnson, DPT, PT
• John Kim Johnson, M.D.
• Josette Jaqueline Johnson, M. D.

• General Practice Dentistry in Greenville, SC
• Providers in Greenville, SC by specialty
• General Practice Dentistry in South Carolina

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.