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Active NPI 1861508715 Individual Practitioner Male Practitioner

Dr. Grady Earl Johnson , DMD

Dentist - General Practice • Jacksonville, FL

Professional Overview & Biography Verified Profile Summary

Dr. Grady Johnson, DMD is a registered healthcare professional specializing in Dentist - General Practice in Jacksonville, FL. Practice services are available at 4273 POINT LA VISTA RD S under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

4273 Point La Vista Rd S

Jacksonville, FL 322076243

Telephone 9043980404
Fax 9043980404

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Jacksonville, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 15.0 Yrs
Regional Practice Density
363 Specialists

Practicing in Jacksonville, FL (7473 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Dentist - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License FL DN 7137

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
074459000 (FL)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
✅
NPI Profile Active January 01, 2011

NPI status registered as active in NPPES database

📍
Updated Practice Location January 01, 2011

Registered at 4273 POINT LA VISTA RD S, JACKSONVILLE, FL 322076243 (Tel: 9043980404)

📍
Updated Business Mailing Address January 01, 2011

Registered at 4273 POINT LA VISTA RD S, JACKSONVILLE, FL 322076243 (Tel: 9043980404)

👤
Provider Name / Credentials Updated January 01, 2011

Recorded as GRADY JOHNSON, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) January 01, 2011

Dentist (License #DN 7137 in FL)

🟢
Initial NPI Registration & Enumeration August 22, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1861508715
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 22, 2006
Last Update: March 07, 2023
Sole Proprietor: Yes
Update or Correct Profile

Mailing Address

4273 Point La Vista Rd S

Jacksonville, FL 322076243

Phone: 9043980404

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.