Kevin Brooks Johnson, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

D9406 Issued in OR

Practice address

333 NW 3Rd Ave
Canby, OR 97013-3602

Phone

(503) 266-2705

Fax

(503) 266-2973

NPI assigned

Dec 20, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1166572800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334102400000",
    "number": "1942364575",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 NW 3RD AVE",
            "city": "CANBY",
            "state": "OR",
            "postal_code": "970133602",
            "telephone_number": "503-266-2705",
            "fax_number": "503-266-2973"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 NW 3RD AVE",
            "city": "CANBY",
            "state": "OR",
            "postal_code": "970133602",
            "telephone_number": "503-266-2705",
            "fax_number": "503-266-2973"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KEVIN",
        "middle_name": "BROOKS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-20",
        "last_updated": "2012-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00010704",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D9406",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• JB Sowles
• Jean a Martin DDS PC
• Abigail Joffe-Aalto
• Alison Johnson, LCSW
• Karla Beth Johnson, LMT
• Sophia H Jones, PSS
• Elizabeth Aila June
• Jessica Ellen Karlson, DPT
• Ivy Meredith Katz, M.A, LPC
• Robert Kelly, MA, CADC-I

• Dentist in Canby, OR
• Providers in Canby, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2012; 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.