R Ryan Johansen, D.D.S.

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

49534949922 Issued in UT

Practice address

7613 Jordan Landing Blvd
Suite 210
West Jordan, UT 84084-1972

Phone

(801) 280-9595

Fax

(801) 280-1169

NPI assigned

Feb 15, 2007

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Jordan Landing Pediatric Dentistry DDS

  • Pediatric Dentistry
  • West Jordan, UT
  • NPI 1265215347
  NPD

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992848956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7613 JORDAN LANDING BLVD",
            "address_2": "SUITE 210",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840841972",
            "telephone_number": "801-280-9595",
            "fax_number": "801-280-1169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7613 JORDAN LANDING BLVD",
            "address_2": "SUITE 210",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840841972",
            "telephone_number": "801-280-9595",
            "fax_number": "801-280-1169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANSEN",
        "first_name": "R RYAN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "UT",
            "license": "49534949922",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jillian Jessop, PHARMD
• Yangzi Maggie Jiang, O.D.
• Cynthia Kay Jimenez
• Marisa Kay Jimenez
• Virginia Jimenez, BCBA
• Richard Bart Johansen, MD
• Richard Eric Johansen, DDS
• John R. Ayre, Jr. DDS PC
• Blake Wilson Johnson, D.O.
• Brian Lafe Johnson, DMD

• Pediatric Dentistry in West Jordan, UT
• Providers in West Jordan, UT by specialty
• Pediatric Dentistry in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.