PHILLIP RANDOLPH JOHNSON
NPI 1356450159
Dentist in San Diego, CA

Q: What is Phillip Johnson's NPI number?

The NPI number for Phillip Johnson is 1356450159. It was assigned to this individual provider in the NPPES registry on August 29, 2006.

Q: What is Phillip Johnson's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: When was this NPI record last updated?

The NPPES record for Phillip Johnson was last updated on March 17, 2018. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since August 29, 2006PECOS Enrolled

5454 EL CAJON BLVD, SAN DIEGO, CA 92115(619) 515-2400 Get Directions Write a Review

NPPES record last updated: March 17, 2018. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 17, 2018, Oct 20, 2017, Mar 3, 2016 (3 updates tracked since 2016).

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About Phillip Randolph Johnson NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

PHILLIP RANDOLPH JOHNSON (NPI 1356450159) is an individual dentist in San Diego, California, licensed in California (51943) and active in the NPI registry since August 2006. He is enrolled in Medicare PECOS and maintains a secondary practice location in Vista.

NPPES Registry Identity

NPI1356450159

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NamePHILLIP RANDOLPH JOHNSON

Location Address5454 EL CAJON BLVDSan Diego, CA 92115-3621

Mailing Address823 Gateway Center WaySan Diego, CA 92102-4541 · (619) 906-4623 · Fax (619) 906-4564

Phone(619) 515-2400

Sole ProprietorNo

Enumeration DateAugust 29, 2006

Last NPPES UpdateMarch 17, 20183 updates tracked since enumeration

✔ NPI 1356450159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in CA · 51943

Definition

A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist.

5454 EL CAJON BLVD, San Diego, CA 92115

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Secondary Practice Location 1

Location 11000 Vale Terrace DrVista, CA 92084-5218 · Phone (760) 407-1220 ext. 109 · Fax (760) 414-3702

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Montana and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Phillip Randolph Johnson is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92115 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$94.87 typical visit price

range $62.10 – $184.71

Typical copayment $23.71 (range $15.52 – $46.17)

Most-billed visit code 99203

Established Patient

$76.87 typical visit price

range $20.62 – $151.42

Typical copayment $19.21 (range $5.15 – $37.85)

Most-billed visit code 99213

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RAMANDEEP SINGH DHILLON M.D.

Family Medicine