NPIMap

Organization Active NPI

Orvis J. R. Johnson DDS,SC

  • Health Maintenance Organization
  • North Fond Du Lac, WI
National Provider Identifier
1063512267
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
5000785-015 Issued in WI
Legal business name
ORVIS J. R. JOHNSON DDS,SC
Practice address
825 Prospect Ave
North Fond Du Lac, WI 54937-1365
Phone
(920) 923-0310
Fax
(920) 923-5335
NPI assigned
Sep 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Orvis Johnson, DDSNPI 1679596316
Title
Dentist
Phone
(920) 923-0310

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X 5000785-015 WI Primary

Addresses

Primary practice location

825 Prospect Ave
North Fond Du Lac, WI 54937-1365

Mailing address

825 Prospect Ave
North Fond Du Lac, WI 54937-1365
Phone (920) 923-0310

National Provider Directory

National Provider Directory

Locations

825 Prospect Ave
North Fond du Lac, WI 54937
Phone (920) 923-0310

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": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063512267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 PROSPECT AVE",
            "city": "NORTH FOND DU LAC",
            "state": "WI",
            "postal_code": "549371365",
            "telephone_number": "920-923-0310",
            "fax_number": "920-923-5335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 PROSPECT AVE",
            "city": "NORTH FOND DU LAC",
            "state": "WI",
            "postal_code": "549371365",
            "telephone_number": "920-923-0310",
            "fax_number": "920-923-5335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORVIS J. R. JOHNSON DDS,SC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ORVIS",
        "authorized_official_title_or_position": "DENTIST",
        "authorized_official_telephone_number": "920-923-0310",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "WI",
            "license": "5000785-015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Fond Du Lac, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.