John Cameron Johnson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

31325 Issued in TX

Practice address

1313 Broadway Ste 5
Lubbock, TX 79401-3209

Phone

(208) 871-7273

NPI assigned

Oct 15, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Jul 8, 2021 through Jul 8, 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 and National Provider Directory roles.

• Casas Adobes Oms PLLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Tucson, AZ
  • NPI 1114125267
  NPD (past)

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

{
    "created_epoch": "1444867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444867200000",
    "number": "1114398245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 BROADWAY, SUITE 5",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "79401",
            "telephone_number": "208-871-7273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 BROADWAY STE 5",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794013209",
            "telephone_number": "208-871-7273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "JOHN",
        "middle_name": "CAMERON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-10-15",
        "last_updated": "2015-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "TX",
            "license": "31325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Johnson, PHARMD
• Heenan Johnson III, DDS
• Jackie Jerome Johnson Sr., LCDC-I
• Jake Johnson, CRNA
• James Matthew Johnson, D.C.
• Joseph Henry Johnson
• Judith Faye Johnson, F.N.P.
• Kandi Johnson, OTR
• Kara Rachelle Johnson, RN
• Kelly Kathryn Johnson, LCSW

• General Practice Dentistry in Lubbock, TX
• Providers in Lubbock, TX by specialty
• General Practice Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.