JOHNSON C MIIN


Address: 1351 Main St, Brockton, MA 02301-7153
Phone: 5085872000

JOHNSON C MIIN (NPI# 1942463898) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1942463898
Entity Type Individual
Full Name JOHNSON C MIIN
Credential DDS, MSE
Practice Address 1351 Main St
Brockton
MA 02301-7153
Practice Telephone 5085872000
Practice Fax Number 5085973552
Enumeration Date 2008-07-09
Last Update Date 2014-10-15
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 122300000X Dentist 8512 KY Dental Providers
Y 1223S0112X Dentist
Specialization: Oral and Maxillofacial Surgery
DN1856466 MA Dental Providers
N 390200000X Student in an Organized Health Care Education/Training Program MS Student, Health Care

Office Location

Street Address 1351 MAIN ST
City BROCKTON
State MA
Zip Code 02301-7153

Providers in the same location

NPI Name Taxonomy Address Enumeration
1730155029 Raphael I. Kieval Internal Medicine 1351 Main St, Rear, Brockton, MA 02301-7153 2006-02-27
1346331006 Brian Chester Sperre Podiatrist 1351 Main St, Brockton, MA 02301-7153 2006-09-27
1487665618 Deborah Diorio Dietitian, Registered 1351 Main St, Brockton, MA 02301 2006-08-11
1457370504 Brockton Oral & Maxillofacial Surgery Inc Dentist 1351 Main St, Brockton, MA 02301 2006-07-19
1609893197 Patricia White Nurse Practitioner 1351 Main St, Brockton, MA 02401 2006-07-17
1174553143 Rheumatology Consultants PC Internal Medicine 1351 Main St, Brockton, MA 02301 2006-07-04
1275588956 Paul Martin Fitzgerald Dentist 1351 Main St, Brockton, MA 02301 2006-05-23
1184679862 Gerald Lewis Goveia Dentist 1351 Main St, Brockton, MA 02301 2006-05-23
1740235431 Joseph A Marino Oral & Maxillofacial Surgery 1351 Main St, Brockton, MA 02301 2006-05-23
1336115666 Ari J Schwartz Internal Medicine 1351 Main St, Brockton, MA 02301-7153 2006-02-27
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1942807110 Jenny Vulpis Recreation Therapist 940 Belmont St (br 135), Brockton, MA 02301 2020-10-01
1205444924 Caroline Storey Counselor Men's Addiction Treatment Center, 10 Meadowbrook Road, Brockton, MA 02301 2020-07-20
1013546852 Nuria Dos Santos Veiga Occupational Therapist 73 Denton St, Brockton, MA 02301 2020-04-03
1679113930 Laura Ann Brondyk II Counselor 10 Christys Dr, Brockton, MA 02301 2020-01-14
1437796521 Andrea Lopes Developmental Therapist 7 Goddard Road, Brockton, MA 02301 2019-12-08
1518420124 Diligencehealthcare Psychiatry & Neurology 30-40 Westpark Street, Brockton, MA 02301 2019-04-10
1124530373 Rachel Theys Behavioral Analyst 130 Liberty St Ste 13a, Brockton, MA 02301 2017-10-27
1689193369 Anderson D Delgado Behavior Technician 11 Packard Way, Brockton, MA 02301 2017-09-14
1811415326 Francesca Lavecchia Clinical Neuropsychologist Brockto Area Multi Service, Inc. 10 Christy Dr., Brockton, MA 02301 2017-09-05
1831615343 Donna Marie Dugan Counselor South Bay Community Services, 340 Main Street - Suite 818, Worcester, MA 02301 2017-08-16
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Taxonomy Information

Taxonomy Code 1223S0112X
Grouping Dental Providers
Classification Dentist
Specialization Oral and Maxillofacial Surgery

Taxonomy Definition

The specialty of dentistry which includes 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.
Notes: Source: Council on Dental Education and Licensure, American Dental Association

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1225115470 Southeastern Oral & Maxillofacial Surgeons PC Dentist 951 North Main Street, Brockton, MA 02301 2006-11-01
1750458451 Oral and Maxillofacial Surgery, Inc. Dentist 830 Oak St, Suite 101w, Brockton, MA 02301-1168 2006-11-29
1225107154 Jeffrey R. Parsons Dentist 830 Oak St, Suite 101w, Brockton, MA 02301-1168 2006-11-07
1548339476 L. Michael Juvet Dentist 830 Oak St, Suite 101w, Brockton, MA 02301-1168 2006-11-07
1538132956 Richard J Catrambone Dentist 830 Oak St, Suite 101w, Brockton, MA 02301-1168 2006-02-08

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1114573508 Newton Dentistry PC Dentist 73 Lexington Street, Suite 204, Newton, MA 02466 2019-08-13
1700432143 Middleboro Oral Surgeons, PC Dentist 47 Bedford St Unit 3, Middleboro, MA 02346-1047 2019-08-12
1508420621 Nantucket Oral Surgery Pllc Dentist 19 1/2 Surfside Drive, Nantucket, MA 02554 2019-04-24
1750844080 C.m.f.-cranio-maxillofacial Surgery Associates Dentist 366 Broadway Ste 100, Somerville, MA 02145-2812 2019-04-12
1669938130 Milagros Serrano Dds, PC Dentist 1842 Beacon St Ste 303, Brookline, MA 02445-1922 2019-02-20
1669960027 New England Family Dentistry,pc Dentist 366 Cooley St, Springfield, MA 01128-1144 2018-05-01
1528592029 Jaegak Kim Dentist 850 Harrison Ave Fl 6, Boston, MA 02118-4001 2017-04-12
1609322452 Lowell Oral Surgery Associates, Inc Dentist 26 North Rd, 2nd Floor, Chelmsford, MA 01824-2722 2016-08-31
1295189280 Jonathan Bishop Dentist 208 Main St Ste 116, Milford, MA 01757-2502 2016-04-16
1790149987 Capeside Oral&facial Surgery, Inc. Dentist 362 Gifford St, Falmouth, MA 02540-2912 2016-04-13
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Competitor

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City BROCKTON
Zip Code 02301

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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