Benjamin Reed Johnson, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

60204550 Issued in WA

Practice address

601 S Carr Rd
Suite 300
Renton, WA 98055-5866

Phone

(425) 466-1185

NPI assigned

Sep 22, 2010

Last updated

Jul 28, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Feb 21, 2023 through Feb 21, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Benjamin Johnson DDS, PLLC.

  dba Pacific Northwest Oral and Maxillofacial Surgeons

  • Oral and Maxillofacial Surgery (Dentist)
  • Burien, WA
  • NPI 1063253672
  NPD (past) Authorized official
• Edwards, Johnson, Johnson & Johnson D.D.S., P.L.L.C.

  dba Pacific Northwest Oral & Maxillofacial Surgeons

  • Oral and Maxillofacial Surgery (Dentist)
  • Renton, WA
  • NPI 1255803904
  NPD (past)

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

{
    "created_epoch": "1285113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1406505600000",
    "number": "1073821286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S CARR RD",
            "address_2": "SUITE 300",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555866",
            "telephone_number": "425-466-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 S CARR RD",
            "address_2": "SUITE 300",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980555866",
            "telephone_number": "425-466-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BENJAMIN",
        "middle_name": "REED",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-22",
        "last_updated": "2014-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019.028413",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "60204550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Andrea L Johnson, OT
• Andrew Miles Johnson, DDS
• Anita Desiree Johnson, SLP
• Arthur Egene Johnson, CDP
• Benjamin Erskine Johnson, PSY.D.
• Carl Kenneth Johnson, DDS
• Cheryl Johnson, PHARMACY TECHNICIAN
• Christopher Johnson
• Courtney Lois Johnson, PA-C
• Erica Leilani Johnson, APRN

• Oral and Maxillofacial Surgery (Dentist) in Renton, WA
• Providers in Renton, WA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.