NPIMap

Organization Active NPI

Michael D. Johnson, D.D.S.,P.C.

  • Dental Clinic/Center
  • Elgin, IL
National Provider Identifier
1477801298
Registry record updated Aug 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
019.020007 Issued in IL
Legal business name
MICHAEL D. JOHNSON, D.D.S.,P.C.
Practice address
2090 Larkin Ave
Unit One-Rear
Elgin, IL 60123-5845
Phone
(847) 741-6217
Fax
(847) 741-6217
NPI assigned
Aug 28, 2012
Last updated
Aug 28, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2012

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

Authorized official

Name
Dr. Michael David Johnson, D.D.S.NPI 1295882645
Title
President
Phone
(847) 741-6217

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 019.020007 IL Primary

Addresses

Primary practice location

2090 Larkin Ave
Unit One-Rear
Elgin, IL 60123-5845

Mailing address

2090 Larkin Ave
Unit One-Rear
Elgin, IL 60123-5845
Phone (847) 741-6217

National Provider Directory

National Provider Directory

Locations

2090 Larkin Ave
Elgin, IL 60123
Phone (847) 741-6217

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1346112000000",
    "number": "1477801298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2090 LARKIN AVE",
            "address_2": "UNIT ONE-REAR",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601235845",
            "telephone_number": "847-741-6217",
            "fax_number": "847-741-6217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 LARKIN AVE",
            "address_2": "UNIT ONE-REAR",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601235845",
            "telephone_number": "847-741-6217",
            "fax_number": "847-741-6217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MICHAEL D. JOHNSON, D.D.S.,P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-28",
        "last_updated": "2012-08-28",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "847-741-6217",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.D.S."
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "IL",
            "license": "019.020007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elgin, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2012; 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.