Active NPI
Johnson DO
- Dental Hygienist
- Spokane, WA
National Provider Identifier
1083454268
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- DH61559217
- Practice address
- 203 E Dalke Ave
Spokane, WA 99208-8112 - Phone
- (509) 444-8200
- NPI assigned
- May 28, 2024
- Last updated
- May 29, 2024
- 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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | DH61559217 | WA | Primary |
Addresses
Primary practice location
203 E Dalke Ave
Spokane, WA 99208-8112
Mailing address
611 N Iron Bridge Way
Spokane, WA 99202-4932
Phone (509) 444-8888
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 |
|---|---|---|---|
| DH61559217 | WA | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1716854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1716940800000",
"number": "1083454268",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "611 N IRON BRIDGE WAY",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992024932",
"telephone_number": "509-444-8888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "203 E DALKE AVE",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992088112",
"telephone_number": "509-444-8200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DO",
"first_name": "JOHNSON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2024-05-28",
"last_updated": "2024-05-29",
"certification_date": "2024-05-29",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "WA",
"license": "DH61559217",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.