Blair Johnson, D.D.S.

Primary specialty

EndodonticsTaxonomy code 1223E0200X

License

4412015 Issued in WI

Practice address

1120 Oak Ridge Dr
Eau Claire, WI 54701-6133

Phone

(715) 834-8414

Fax

(715) 834-3557

NPI assigned

Nov 15, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WI

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

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Family Therapy Associates, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New Richmond, WI
  • NPI 1215239736
  NPD (past)
• Oral and Maxillofacial Surgery Asso of Eau Claire SC

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Altoona, WI
  • NPI 1316954928

  Endodontics

  NPD (past)

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

{
    "created_epoch": "1163548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1417029158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 OAK RIDGE DR",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016133",
            "telephone_number": "715-834-8414",
            "fax_number": "715-834-3557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 OAK RIDGE DR",
            "city": "EAU CLAIRE",
            "state": "WI",
            "postal_code": "547016133",
            "telephone_number": "715-834-8414",
            "fax_number": "715-834-3557"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BLAIR",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "WI",
            "license": "4412015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jake Jochimsen, OD
• Jackie T Joday, MSW
• Tyler John
• Adam Craig Johnson, CRNA
• Aimee Desiree Johnson, LMT
• Carolyn J Johnson, PHARMD
• Carrie Lynn Johnson, COTA
• Chloe Bea Johnson
• Christopher D Johnson, D.D.S.
• Deborah L Johnson, M.D.

• Endodontics in Eau Claire, WI
• Providers in Eau Claire, WI by specialty
• Endodontics in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.