Benjamin S Johnson, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

6240-15 Issued in WI

Practice address

134 S 4TH St
Delavan, WI 53115-1802

Phone

(262) 728-9330

Fax

(262) 728-0172

NPI assigned

Jun 18, 2008

Last updated

Jun 18, 2008By the provider in NPPES

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

Enrolled in WI

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Benjamin S Johnson DDS SC

  dba The Dentist

  • Dentist
  • Delavan, WI
  • NPI 1285067272
  Authorized official Same address or phone

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

{
    "created_epoch": "1213747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1306007737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "134 S 4TH ST",
            "city": "DELAVAN",
            "state": "WI",
            "postal_code": "531151802",
            "telephone_number": "262-728-9330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 S 4TH ST",
            "city": "DELAVAN",
            "state": "WI",
            "postal_code": "531151802",
            "telephone_number": "262-728-9330",
            "fax_number": "262-728-0172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BENJAMIN",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-18",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6240-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Krista Lynn Huerta, MS OTR/L
• Joseph B Iselin, PHYSICAL THERAPIST
• Jill Jackson, M.S.
• Sheryl Jacobson, RPH
• Joel Sperling DC LLC
• Samantha Ryan Johnson, DDS
• Jeffrey J Johnston, PT
• Tesalia R Jordens, D.O.
• Jennifer A Junghen, APRN, DNP
• Shelby Marilyn Marie Kallio-Crotteau, PTA

• Dentist in Delavan, WI
• Providers in Delavan, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.