Thomas Johnson, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

30.027584 Issued in OH

Practice address

4100 W 3Rd St
Dayton, OH 45428-9000

Phone

(937) 684-0890

NPI assigned

Jun 11, 2024

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1718064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718496000000",
    "number": "1265274096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "759 PLANTATION LN",
            "city": "KETTERING",
            "state": "OH",
            "postal_code": "454191117",
            "telephone_number": "937-684-0890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4100 W 3RD ST",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454289000",
            "telephone_number": "937-684-0890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "THOMAS",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-06-11",
        "last_updated": "2024-06-16",
        "certification_date": "2024-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.027584",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shereca Johnson
• Shirley Ann Johnson, OHIO LICDC-CSAND LSW
• Stephanie Fantauzzo Johnson, OTRL
• Taiya Johnson, LVN, CDCA
• Taylor Johnson
• Tierra Lashelle Johnson
• Tracie Y Johnson, LSW
• Tyler Johnson, PEER SUPPORT
• Wanda Johnson
• Willetta Doris Johnson, COTA/L

• Dentist in Dayton, OH
• Providers in Dayton, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 16, 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.

Verify at the official NPI Registry.