David Clark Johnson, DDS, MS

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

8786 Issued in CO

Practice address

1029 Robertson St
Fort Collins, CO 80524-3926

Phone

(970) 447-3746

Fax

(970) 447-3747

NPI assigned

Apr 10, 2006

Last updated

Jul 14, 2025By 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 1

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 1, 2018 through Feb 1, 2028

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Poudre Valley Periodontics & Dental Implants

  • Periodontics
  • Fort Collins, CO
  • NPI 1376453472
  Authorized official Same address or phone
• Merritt Periodontics P.C.

  dba Associates in Periodontics

  • Periodontics
  • Fort Collins, CO
  • NPI 1760802102
  NPD (past)

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

{
    "created_epoch": "1144627200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752451200000",
    "number": "1194788141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1029 ROBERTSON ST",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243926",
            "telephone_number": "970-447-3746",
            "fax_number": "970-447-3747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1029 ROBERTSON ST",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805243926",
            "telephone_number": "970-447-3746",
            "fax_number": "970-447-3747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DAVID",
        "middle_name": "CLARK",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-10",
        "last_updated": "2025-07-14",
        "certification_date": "2025-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CO",
            "license": "8786",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brienna Johnson, APRN
• Camille C Johnson, RN
• Catharine Danila Johnson, REGISTERED NURSE
• Charles Dustin Johnson, M.S., ED.S.
• Charles Timothy Johnson, M.D.
• David William Johnson, D.C.
• Douglas William Johnson
• Elisa Joy Lewis Johnson
• Estee Johnson, PT, DPT
• Heather Johnson, LMFT

• Periodontics in Fort Collins, CO
• Providers in Fort Collins, CO by specialty
• Periodontics in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2025; 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.