JOHN ANTHONY JOHNSON D.M.D. M.D. NPI 1639174162

NPI Information

  • NPI: 1639174162
  • Provider Name: JOHN ANTHONY JOHNSON, D.M.D., M.D.
  • Classification: Dentist - 1223S0112X
  • Specialization: Oral and Maxillofacial Surgery
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 858 BRAWLEY SCHOOL RD
    STE C
    MOORESVILLE, NC
    ZIP 28117
  • Phone: (704) 799-3555

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NPI Details

John Anthony Johnson, D.M.D., M.D. is an oral and maxillofacial surgery dentist in Mooresville, NC. The provider is an oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. John Anthony Johnson, D.M.D., M.D. NPI is 1639174162. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

858 BRAWLEY SCHOOL RD
STE C
MOORESVILLE, NC
ZIP 28117-852
Phone: (704) 799-3555
Fax: (704) 799-3095

The NPI 1639174162 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • X-ray of lower jaws, upper jaws and teeth (HCPCS:70355)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)

The enumeration date for this NPI number is 6/21/2005 and was last updated on 7/8/2007.

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
11223S0112XDentistOral and Maxillofacial SurgeryNORTH CAROLINAYes

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
189136CUMEDICAIDNORTH CAROLINA
22001524AMEDICARE ID-TYPE UNSPECIFIEDNORTH CAROLINA
3H76694MEDICARE UPINNORTH CAROLINA

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: 11/21/2025

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