Summers and Johnson Periodontal Partnership

Primary specialty

DentistTaxonomy code 122300000X

License

5854 Issued in NC

Legal business name

SUMMERS AND JOHNSON PERIODONTAL PARTNERSHIP

Practice address

108 Oakmont Drive
Greenville, NC 27858

Phone

(252) 756-1456

Fax

(252) 317-8335

NPI assigned

Jul 11, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Brian R Summers, DDS MS

Title

President

Phone

(252) 756-1456

Specialties & licenses 2

Addresses

Other identifiers 2

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1982638193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "108 OAKMONT DRIVE",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "27858",
            "telephone_number": "252-756-1456",
            "fax_number": "252-317-8335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "108 OAKMONT DRIVE",
            "city": "GREENVILLE",
            "state": "NC",
            "postal_code": "27858",
            "telephone_number": "252-756-1456",
            "fax_number": "252-317-8335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUMMERS AND JOHNSON PERIODONTAL PARTNERSHIP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SUMMERS",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "252-756-1456",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS MS"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "5854",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dentist",
            "state": "NC",
            "license": "6573",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "98211",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "90248",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Caitlin F Sullivan, LCSWA
• Catherine Sullivan, RD, LDN, MPH
• Tiara Shannelle Sullivan, LCAS-A, LCMHCA
• Ursula Lynell Sullivan, PA-C
• Minnie Lue Sumerlin, FNP
• Brian R Summers, D.D.S.,M.S.
• Lisa Summers
• Sunshine Theraputic Services, LLC
• Kajuan Supel, M.A, BCBA, LBA
• Supports Plus LLC

• Dentist in Greenville, NC
• Providers in Greenville, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.