Stephen P Johansen, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

0401005877 Issued in VA

Practice address

6441 Ironbridge Road
Richmond, VA 23113

Phone

(804) 743-8166

Fax

(804) 743-4818

NPI assigned

Jan 16, 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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Sep 23, 2016 through Sep 23, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Virginia Family Dentistry PC

  • General Practice Dentistry
  • Midlothian, VA
  • NPI 1750435970
  NPD (past)

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992857510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1612 HUGUENOT ROAD",
            "city": "MIDLOTHIAN",
            "state": "VA",
            "postal_code": "23113",
            "telephone_number": "804-794-9789",
            "fax_number": "804-794-9762"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6441 IRONBRIDGE ROAD",
            "city": "RICHMOND",
            "state": "VA",
            "postal_code": "23113",
            "telephone_number": "804-743-8166",
            "fax_number": "804-743-4818"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANSEN",
        "first_name": "STEPHEN",
        "middle_name": "P",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "VA",
            "license": "0401005877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Elizabeth Jobes, PA
• Gabriella Joffe
• Johairinc LLC
• Carmen C Johanning, D.C.
• Sharon Kay Johansen, A.T.C.
• John H Pope Jr MD PLLC
• John J. Bagley, Jr, M.D., P.C.
• John Kittrell DDS
• John Randolph OB/GYN, LLC
• Abbie John

• Dentist in Richmond, VA
• Providers in Richmond, VA by specialty
• Dentist in Virginia

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.