David Ross Johnson

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2901015613 Issued in MI

Practice address

15510 Livernois Ave
Detroit, MI 48238-1343

Phone

(313) 863-2800

NPI assigned

Apr 13, 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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194949735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15510 LIVERNOIS AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482381343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15510 LIVERNOIS AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482381343",
            "telephone_number": "313-863-2800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DAVID",
        "middle_name": "ROSS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901015613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Damita Johnson
• Danaesha Johnson
• Danielle Lynette Johnson, B.A. CHW
• Darryl Lavez Johnson
• David Johnson
• Dawnielle Lavette Johnson, HT
• Deborah Angela Johnson, L.L.P.
• Deborah Ruth Johnson, NP
• Delisa Johnson, SOCIAL WORKER BSW
• Denise Johnson, LCSW

• General Practice Dentistry in Detroit, MI
• Providers in Detroit, MI by specialty
• General Practice Dentistry in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.