Active NPI
Ryan Johnson, DMD
- Periodontics
- Oak Brook, IL
National Provider Identifier
1447924808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Periodontics
- License
- 021.003528
- Practice address
- 120 Oakbrook Ctr Ste 714
Oak Brook, IL 60523-1831 - Phone
- (630) 654-3331
- Fax
- (630) 954-2910
- NPI assigned
- Aug 9, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Periodontics | 1223P0300X | 021.003528 | IL | Primary |
Addresses
Primary practice location
120 Oakbrook Ctr Ste 714
Oak Brook, IL 60523-1831
Mailing address
958 Kensington Dr
Northbrook, IL 60062-5975
Phone (941) 914-5056
Other practice location 1
23909 W Renwick Rd Ste 103
Plainfield, IL 60544-2109
Phone (815) 609-3636
Other practice location 2
1641 N Milwaukee Ave Ste 3
Libertyville, IL 60048-1386
Phone (847) 349-4306
Other practice location 3
720 Brom Ct Ste 102
Naperville, IL 60540-6533
Phone (630) 717-6717
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13966 | CT | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Oakbrook Endodontic Associates, LTD. | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Endodontics
- Oak Brook, IL
- NPI 1104972694
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1628467200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783641600000",
"number": "1447924808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "958 KENSINGTON DR",
"city": "NORTHBROOK",
"state": "IL",
"postal_code": "600625975",
"telephone_number": "941-914-5056"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "120 OAKBROOK CTR STE 714",
"city": "OAK BROOK",
"state": "IL",
"postal_code": "605231831",
"telephone_number": "630-654-3331",
"fax_number": "630-954-2910"
}
],
"practiceLocations": [
{
"address_1": "23909 W Renwick Rd Ste 103",
"address_purpose": "LOCATION",
"city": "Plainfield",
"state": "IL",
"postal_code": "605442109",
"country_code": "US",
"telephone_number": "815-609-3636",
"fax_number": "815-609-3399",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1641 N Milwaukee Ave Ste 3",
"address_purpose": "LOCATION",
"city": "Libertyville",
"state": "IL",
"postal_code": "600481386",
"country_code": "US",
"telephone_number": "847-349-4306",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "720 Brom Ct Ste 102",
"address_purpose": "LOCATION",
"city": "Naperville",
"state": "IL",
"postal_code": "605406533",
"country_code": "US",
"telephone_number": "630-717-6717",
"fax_number": "630-717-7790",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "JOHNSON",
"first_name": "RYAN",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-08-09",
"last_updated": "2026-07-10",
"certification_date": "2026-07-10",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0300X",
"taxonomy_group": "",
"desc": "Dentist, Periodontics",
"state": "IL",
"license": "021.003528",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Oak Brook, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.