JIMMIE LEE JOHNSON DMD PSC NPI 1578605978

NPI Information

  • NPI: 1578605978
  • Provider Name: JIMMIE LEE JOHNSON DMD PSC
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Organization
  • Other Name: PSC A SUB S CORPORATION
  • Address: 87 WILDWOOD PLACE
    IRVINE, KY
    ZIP 40336
  • Phone: (606) 723-3213

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NPI Details

JIMMIE LEE JOHNSON DMD PSC is a general practice dentist in Irvine, KY. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. JIMMIE LEE JOHNSON DMD PSC NPI is 1578605978. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Psc A Sub S Corporation.

The provider's business location address is:

87 WILDWOOD PLACE
IRVINE, KY
ZIP 40336-312
Phone: (606) 723-3213
Fax: (606) 723-3213

The provider's authorized official is Jimmie Lee Johnson .
The authorized official title is Dentist and has the following contact phone number (606) 723-3213.

The enumeration date for this NPI number is 2/13/2007 and was last updated on 3/25/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral Practice6163KENTUCKYYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
160061637MEDICAIDKENTUCKY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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