South Plains Pediatric Dental Group

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

17087 Issued in TX

Legal business name

SOUTH PLAINS PEDIATRIC DENTAL GROUP

Doing business as

John S Johnson, DDS

Practice address

5102 Salem Ave
Lubbock, TX 79414-4036

Phone

(806) 687-8080

Fax

(806) 771-6862

NPI assigned

Feb 9, 2009

Last updated

Feb 9, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. John Johnson, DDS

Title

Owner

Phone

(806) 687-8080

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• John S Johnson, DDS Doing business as

Tax ID family

John S Johnson DDS2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• John S Johnson, DDS, PA

  dba John S Johnson, DDS

  • Pediatric Dentistry
  • Lubbock, TX
  • NPI 1487930129
  NPD tax ID

Locations

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

{
    "created_epoch": "1234137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1234137600000",
    "number": "1972742302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5102 SALEM AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794144036",
            "telephone_number": "806-687-8080",
            "fax_number": "806-771-6862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5102 SALEM AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794144036",
            "telephone_number": "806-687-8080",
            "fax_number": "806-771-6862"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH PLAINS PEDIATRIC DENTAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-02-09",
        "last_updated": "2009-02-09",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "806-687-8080",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TX",
            "license": "17087",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CSHCN (PROGRAM IN TEXAS FOR DISABLED CHILDREN)",
            "identifier": "079145101",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "John S Johnson, DDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• South Plains Pathology Inc
• South Plains Pediatric Cardiology, P.a.
• South Plains Pediatric Dental Group
• South Plains Pediatric Dental Group
• South Plains Pediatric Dental Group
• South Plains Rehabilitation Hospital, LLC (South Plains Rehab Hospital, an affiliate of UMC and Encompass Health)
• South Plains Rural Health Services, Inc
• South Plains Surgery Center LLC
• South Plains Surgical Associates
• South Plains Therapy Services, LLC

• Pediatric Dentistry in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Pediatric Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2009; 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.