Tracy R. Johnson, DDS, PS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

DE00008961 Issued in WA

Legal business name

TRACY R. JOHNSON, DDS, PS

Practice address

2040 Mitchell Rd SE
Port Orchard, WA 98366-4401

Phone

(360) 895-8841

Fax

(360) 895-9350

NPI assigned

Apr 24, 2008

Last updated

Apr 24, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Tracy R Johnson, DDSNPI 1548241219

Title

President/Owner

Phone

(360) 895-8841

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Locations

Practitioners 5

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.

• Tracy R Johnson, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Lakewood, WA
  • NPI 1548241219
  Medicare reassignment NPD Authorized official
• Audra Alexandra Boehm

  • Oral and Maxillofacial Surgery (Dentist)
  • Silverdale, WA
  • NPI 1811452303
  Medicare reassignment
• David A Cotant, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Lakewood, WA
  • NPI 1689708620
  NPD (past)
• Andrew J Tellington, D.M.D

  • Oral and Maxillofacial Surgery (Dentist)
  • Port Orchard, WA
  • NPI 1174717524
  NPD (past)
• William Bradford Hepworth, MD

  • General Practice Physician
  • Cedar Hills, UT
  • NPI 1609830538

  Oral and Maxillofacial Surgery

  NPD (past)

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

{
    "created_epoch": "1208995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1208995200000",
    "number": "1376718957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3377 BETHEL RD SE STE 107",
            "address_2": "PMB 184",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983665608",
            "telephone_number": "360-895-8841",
            "fax_number": "360-895-9350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2040 MITCHELL RD SE",
            "city": "PORT ORCHARD",
            "state": "WA",
            "postal_code": "983664401",
            "telephone_number": "360-895-8841",
            "fax_number": "360-895-9350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRACY R. JOHNSON, DDS, PS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-24",
        "last_updated": "2008-04-24",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "TRACY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "360-895-8841",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "WA",
            "license": "DE00008961",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph Tintera, RDN
• Tiny Notes Music and Movement LLC (Tiny Notes Enrichment Center)
• Victoria Annette Tippery
• Heather B. Tonder
• Gwendolyn Marie Torgerson, M.S. CCC-SLP
• Donald Tracy, R.PH
• Marsha Trivett
• Trisha Trujillo, O.T.D., OTR/L
• Joseph C Trull, OD
• Alizabeth Lechi Truong, MD

• Oral and Maxillofacial Surgery (Dentist) in Port Orchard, WA
• Providers in Port Orchard, WA by specialty
• Oral and Maxillofacial Surgery (Dentist) in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.