Todd A Johnson, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1001483 Issued in WI

Practice address

5702 Memorial CT
Weston, WI 54476-6502

Phone

(715) 496-1128

Fax

(715) 972-8123

NPI assigned

Dec 7, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mountain Bay Dental LLC

  • General Practice Dentistry
  • Champaign, IL
  • NPI 1295268019
  NPD (past)

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

{
    "created_epoch": "1165449600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492128000000",
    "number": "1407915291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5702 MEMORIAL CT",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544766502",
            "telephone_number": "715-496-1128",
            "fax_number": "715-972-8123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5702 MEMORIAL CT",
            "city": "WESTON",
            "state": "WI",
            "postal_code": "544766502",
            "telephone_number": "715-496-1128",
            "fax_number": "715-972-8123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TODD",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-07",
        "last_updated": "2017-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IL",
            "license": "019025511",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1001483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1004971",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacobson Counseling LLC
• Shannon Marie Jahn, NP-C
• Charlene A Janeczko-King, DDS
• Eromi S Jayasingha, MD
• Alison Robin Johnson, LPC-IT
• Coy H Johnston III, MD
• Lisa Marsha Jones, MD
• Wendy A Jones, APNP
• Samuel Joswiak
• Diane M. Joyce, NP

• General Practice Dentistry in Weston, WI
• Providers in Weston, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2017; 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.