Active NPI
Brock Jonathan Johnson, DDS
- Dentist
- Yuma, CO
National Provider Identifier
1013049006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 9241
- Practice address
- 900 S. Ash St.
Yuma, CO 80759 - Phone
- (970) 848-5777
- NPI assigned
- Mar 12, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dentist | 122300000X | 9241 | CO | Primary |
Addresses
Primary practice location
900 S. Ash St.
Yuma, CO 80759
Mailing address
615 S Cedar St
Yuma, CO 80759-2713
Phone (970) 848-0960
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9241 | CO | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yuma Family Dental, P.C. | Past | Accepting new patients | |
| BGR Dental, PLLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Dental Clinic/Center
- Yuma, CO
- NPI 1265608160
-
- Dental Clinic/Center
- Yuma, CO
- NPI 1972913960
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173657600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1187136000000",
"number": "1013049006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "615 S CEDAR ST",
"city": "YUMA",
"state": "CO",
"postal_code": "807592713",
"telephone_number": "970-848-0960"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 S. ASH ST.",
"city": "YUMA",
"state": "CO",
"postal_code": "80759",
"telephone_number": "970-848-5777"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "BROCK",
"middle_name": "JONATHAN",
"credential": "DDS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-03-12",
"last_updated": "2007-08-15",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "CO",
"license": "9241",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Yuma, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.