Individual provider Active NPI

Steven William Johnson, D.D.S.

  • Dentist
  • Louisville, CO
National Provider Identifier
1407177561
Registry record updated Dec 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
30.024187 Issued in OH
Practice address
275 Century Cir
Suite 200
Louisville, CO 80027-9729
Phone
(303) 666-4499
Fax
(303) 666-2119
NPI assigned
Jun 11, 2010
Last updated
Dec 30, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 30.024187 OH Primary

Addresses

Primary practice location

275 Century Cir
Suite 200
Louisville, CO 80027-9729

Mailing address

6551 Minnewaukan Dr
Cincinnati, OH 45243-2405
Phone (720) 273-9176

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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

Enrollment IDStateProvider typePAC IDDetails
I20160105001968 OH Order and Referring Only - DentistPractitioner - Dentist 0042512204

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
30.024187OHMDDentist

NPI Registry JSON

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

{
    "created_epoch": "1276214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451433600000",
    "number": "1407177561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6551 MINNEWAUKAN DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452432405",
            "telephone_number": "720-273-9176"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 CENTURY CIR",
            "address_2": "SUITE 200",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800279729",
            "telephone_number": "303-666-4499",
            "fax_number": "303-666-2119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "STEVEN",
        "middle_name": "WILLIAM",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-06-11",
        "last_updated": "2015-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30.024187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, CO

Sources for this page

Verify at the official NPI Registry.