Johnson C Miin, DDS, MSE

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DN1856466 Issued in MA

Practice address

1351 Main St
Brockton, MA 02301-7153

Phone

(508) 587-2000

Fax

(508) 597-3552

NPI assigned

Jul 9, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413331200000",
    "number": "1942463898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1351 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023017153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1351 MAIN ST",
            "city": "BROCKTON",
            "state": "MA",
            "postal_code": "023017153",
            "telephone_number": "508-587-2000",
            "fax_number": "508-597-3552"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIIN",
        "first_name": "JOHNSON",
        "middle_name": "C",
        "credential": "DDS, MSE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-09",
        "last_updated": "2014-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MS",
            "license": null,
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "KY",
            "license": "8512",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MA",
            "license": "DN1856466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackendy Michel
• Harold Michlewitz, M.D.
• Bruce Micley, OD
• Menardine Midy
• Tatiana Mihaita, CTRS
• Gary H Mikels, DMD
• Maikel Mikhail
• Alexander Miklave
• Miles Towards Health and Wellness PLLC
• Dasia Miles-Langaigne

• Oral and Maxillofacial Surgery (Dentist) in Brockton, MA
• Providers in Brockton, MA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2014; 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.