Organization Active NPI

Oral Health Clinic PC

  • Dental Clinic/Center
  • Pleasant Hill, IA
National Provider Identifier
1053579201
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
8353 Issued in IA
Legal business name
ORAL HEALTH CLINIC PC
Practice address
1225 Copper Creek Dr Suite K
Pleasant Hill, IA 50327-7091
Phone
(515) 266-3700
Fax
(515) 266-3597
NPI assigned
May 23, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Chadwick Aaron Johnson, DDS
Title
President
Phone
(515) 266-3700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 8353 IA Primary

Addresses

Primary practice location

1225 Copper Creek Dr Suite K
Pleasant Hill, IA 50327-7091

Mailing address

1225 Copper Creek Dr Suite K
Pleasant Hill, IA 50327-7091
Phone (515) 266-3700

Other identifiers 1

IdentifierTypeStateIssuer
0462705MedicaidIA

National Provider Directory

National Provider Directory

Locations

1225 Copper Creek Dr
Ste K
Pleasant Hill, IA 50327
Phone (515) 266-3700

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1211500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741046400000",
    "number": "1053579201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 COPPER CREEK DR SUITE K",
            "city": "PLEASANT HILL",
            "state": "IA",
            "postal_code": "503277091",
            "telephone_number": "515-266-3700",
            "fax_number": "515-266-3597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 COPPER CREEK DR SUITE K",
            "city": "PLEASANT HILL",
            "state": "IA",
            "postal_code": "503277091",
            "telephone_number": "515-266-3700",
            "fax_number": "515-266-3597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORAL HEALTH CLINIC PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-23",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "CHADWICK",
        "authorized_official_middle_name": "AARON",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "515-266-3700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IA",
            "license": "8353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0462705",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pleasant Hill, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.