Matthew Johnson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

61523 Issued in CA

Practice address

110 S 59TH St
Springfield, OR 97478-6975

Phone

(541) 747-8030

NPI assigned

Sep 28, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: mjohnson812477@direct.ochin.org

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.

• McKenzie Dental Center

  • General Practice Dentistry
  • Springfield, OR
  • NPI 1588225155
  NPD (past)

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

{
    "created_epoch": "1348790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440547200000",
    "number": "1295086338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 S 59TH ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974786975",
            "telephone_number": "541-747-8030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S 59TH ST",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974786975",
            "telephone_number": "541-747-8030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MATTHEW",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-28",
        "last_updated": "2015-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "61523",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OR",
            "license": "D10204",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christy L Johnson
• Eric Anders Johnson, M.D.
• Janet Lynn Johnson, QMHA
• Joyce Johnson, L.D.
• Kelly Lynn Johnson, CPT
• Monica Johnson
• Sophia Loren Johnson, PHARMD
• Georgia Johnston
• Karen F Johnston, LCSW
• Leah Johnston, D.P.T.

• Dentist in Springfield, OR
• Providers in Springfield, OR by specialty
• Dentist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2015; 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.