Active NPI
Poudre Valley Periodontics & Dental Implants
- Periodontics
- Fort Collins, CO
National Provider Identifier
1376453472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- Legal business name
- POUDRE VALLEY PERIODONTICS & DENTAL IMPLANTS
- Practice address
- 1029 Robertson St
Fort Collins, CO 80524-3926 - Phone
- (970) 447-3746
- Fax
- (970) 447-3747
- NPI assigned
- Sep 10, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- David Clark Johnson, DDS, MS
- Title
- President/Owner
- Phone
- (970) 447-3746
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | Primary |
Addresses
Primary practice location
1029 Robertson St
Fort Collins, CO 80524-3926
Mailing address
1029 Robertson St
Fort Collins, CO 80524-3926
Phone (970) 447-3746
National Provider Directory
National Provider DirectoryLocations
1029 Robertson St
Fort Collins, CO 80524
Phone (970) 227-4611
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Periodontics
- Fort Collins, CO
- NPI 1194788141
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1788998400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1788998400000",
"number": "1376453472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1029 ROBERTSON ST",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805243926",
"telephone_number": "970-447-3746",
"fax_number": "970-447-3747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1029 ROBERTSON ST",
"city": "FORT COLLINS",
"state": "CO",
"postal_code": "805243926",
"telephone_number": "970-447-3746",
"fax_number": "970-447-3747"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "POUDRE VALLEY PERIODONTICS & DENTAL IMPLANTS",
"organizational_subpart": "NO",
"enumeration_date": "2026-09-10",
"last_updated": "2026-09-10",
"certification_date": "2026-09-10",
"status": "A",
"authorized_official_last_name": "JOHNSON",
"authorized_official_first_name": "DAVID",
"authorized_official_middle_name": "CLARK",
"authorized_official_title_or_position": "PRESIDENT/OWNER",
"authorized_official_telephone_number": "970-447-3746",
"authorized_official_credential": "DDS, MS"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Periodontics",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Collins, CO
- Poudre Valley Medical Group, LLC (UCHealth Medical Group)
- Poudre Valley Medical Group, LLC (UCHealth Medical Group)
- Poudre Valley Medical Group, LLC (UCHealth Medical Group)
- Poudre Valley Medical Group, LLC (UCHealth Medical Group)
- Poudre Valley Open MRI, LLC
- Poudre Valley Radiation Oncology LLC
- Elaine Marie Poulin, PHD
- Matthew David Pouliot, D.O.
- Anne Karen Poulson, MA, MED, LPC, NCC
- Jennifer Jean Poulson, FNP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.