Dennis Douglas Johnson, D.M.D.

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

D4839 Issued in OR

Practice address

410 Lancaster Dr NE
Suite a
Salem, OR 97301-4794

Phone

(503) 581-9419

Fax

(503) 581-0438

NPI assigned

Apr 12, 2007

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1124242813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 LANCASTER DR NE",
            "address_2": "SUITE A",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014794",
            "telephone_number": "503-581-9419",
            "fax_number": "503-581-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 LANCASTER DR NE",
            "address_2": "SUITE A",
            "city": "SALEM",
            "state": "OR",
            "postal_code": "973014794",
            "telephone_number": "503-581-9419",
            "fax_number": "503-581-0438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DENNIS",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "OR",
            "license": "D4839",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14097-0",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Craig Brian Johnson, D.C.
• Damion Johnson
• Darryl Johnson, R.PH.
• David M Johnson
• Deborah M Johnson, MD
• Destyne Faeth Johnson, RDH
• Elizabeth Susan Johnson, CADC II
• Geneva M. Johnson
• James V. Johnson
• Jennifer Johnson

• Oral and Maxillofacial Surgery (Dentist) in Salem, OR
• Providers in Salem, OR by specialty
• Oral and Maxillofacial Surgery (Dentist) in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.