Jay Wilson Johnson I, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12007800A Issued in IN

Practice address

BLDG H 2005 Knight Lane
Navy Medicine Support Command Attn: Medical Staff SVCS
Jacksonville, FL 32212-0140

Phone

(760) 725-5102

NPI assigned

Dec 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

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": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1233619200000",
    "number": "1992780746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 555221",
            "city": "CAMP PENDLETON",
            "state": "CA",
            "postal_code": "920555221",
            "telephone_number": "760-725-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "BLDG H 2005 KNIGHT LANE",
            "address_2": "NAVY MEDICINE SUPPORT COMMAND ATTN: MEDICAL STAFF SVCS",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322120140",
            "telephone_number": "760-725-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JAY",
        "middle_name": "WILSON",
        "name_prefix": "Dr.",
        "name_suffix": "I",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2009-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12007800A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ian Johnson
• Jamie Yvonne Johnson, M.D.
• Janet Johnson
• Janet Dheandriana Johnson, RN
• Janna Johnson
• Jennifer Johnson, PA
• Jerriston Johnson, BSN
• Jessica Alice Johnson, APRN
• Jessica Marie Johnson, PA-C
• Jessica Nicole Johnson, RBT

• General Practice Dentistry in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• General Practice Dentistry in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 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.