Larry a Johnson DDS PC

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

12356 Issued in MA

Legal business name

LARRY A JOHNSON DDS PC

Practice address

69 Hall Road
Sturbridge, MA 01566

Phone

(508) 347-2673

Fax

(508) 347-5085

NPI assigned

Oct 11, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Larry A Johnson, DDS

Title

Periodentist

Phone

(508) 347-2673

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1160524800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437247889",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "69 HALL ROAD",
            "city": "STURBRIDGE",
            "state": "MA",
            "postal_code": "01566",
            "telephone_number": "508-347-2673",
            "fax_number": "508-347-5085"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "69 HALL ROAD",
            "city": "STURBRIDGE",
            "state": "MA",
            "postal_code": "01566",
            "telephone_number": "508-347-2673",
            "fax_number": "508-347-5085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LARRY A JOHNSON DDS PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "LARRY",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PERIODENTIST",
        "authorized_official_telephone_number": "508-347-2673",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist, Periodontics",
            "state": "MA",
            "license": "12356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kara Emily Krantz
• Randi Adele Krogstad, MSW
• Mikayla Kurtz, M.S., BCBA
• Nicholas Kenneth Lamura, DDS
• Jenna Maureen Larocque, O.D
• Susan B Lasewicz, PT, ATC
• Hannah Leahey, DMD
• Booker T Lester, MSW
• Alina Lillis, OTR
• Monica Lindsay, DPT

• Periodontics in Sturbridge, MA
• Providers in Sturbridge, MA by specialty
• Periodontics in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.