Individual provider Active NPI

Lowell Thomas Johnson, DDS

  • Dentist
  • Milwaukee, WI
National Provider Identifier
1316102940
Registry record updated Nov 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4001695 - 015 Issued in WI
Practice address
6040 N Kent Ave
Milwaukee, WI 53217-4644
Phone
(414) 332-8008
NPI assigned
Jul 23, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 11, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 4001695 - 015 WI Primary

Addresses

Primary practice location

6040 N Kent Ave
Milwaukee, WI 53217-4644

Mailing address

6040 N Kent Ave
Marquette University School of Dentistry
Milwaukee, WI 53217-4644
Phone (414) 332-8008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
4001695 - 015WIMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1216771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1320969600000",
    "number": "1316102940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6040 N KENT AVE",
            "address_2": "MARQUETTE UNIVERSITY SCHOOL OF DENTISTRY",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532174644",
            "telephone_number": "414-332-8008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 N KENT AVE",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532174644",
            "telephone_number": "414-332-8008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LOWELL",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-23",
        "last_updated": "2011-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "4001695 - 015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2011; 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.