Michael Allan Johnson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

8911 Issued in SC

Practice address

133 Towne Centre Parkway
Myrtle Beach, SC 29579-3493

Phone

(843) 449-1621

Fax

(843) 903-3840

NPI assigned

Mar 27, 2012

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 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Yes, effective Oct 21, 2022 through Oct 21, 2026

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Coastal Carolina Cosmetic Facial Surgery

  • Oral and Maxillofacial Surgery Clinic/Center
  • Myrtle Beach, SC
  • NPI 1972081941
  NPD Authorized official
• Coastal Carolina Oral Maxillofacial Surgery

  • Oral and Maxillofacial Surgery (Dentist)
  • Myrtle Beach, SC
  • NPI 1194812339
  NPD

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

{
    "created_epoch": "1332806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1427324243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "133 TOWNE CENTRE PARKWAY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295793493",
            "telephone_number": "843-449-1621",
            "fax_number": "843-903-3840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 TOWNE CENTRE PARKWAY",
            "city": "MYRTLE BEACH",
            "state": "SC",
            "postal_code": "295793493",
            "telephone_number": "843-449-1621",
            "fax_number": "843-903-3840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHAEL",
        "middle_name": "ALLAN",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-27",
        "last_updated": "2024-11-06",
        "certification_date": "2019-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SC",
            "license": "958",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "SC",
            "license": "8911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ORAL & MAXILLOFACIAL SURGERY LICENSE",
            "identifier": "958",
            "state": "SC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DENTAL LICENSE",
            "identifier": "8811",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jabrellia C Johnson, LMT
• Jessica Louise Johnson, HIS
• Kaliyah Shanice Johnson, NA
• Kelli Johnson
• Lindsay Marie Johnson, PA
• Nancy Lauren Johnson, FNP
• Sandy Michelle Johnson, M.S. LPC, NCC, CCTP
• Tabitha Ann Johnson, LPN
• Trevor Scott Johnson
• Danielle Renee Johnston, LPC

• Dentist in Myrtle Beach, SC
• Providers in Myrtle Beach, SC by specialty
• Dentist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2024; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.