Active NPI
Tracey Perry Johnson, RDH
- Dental Hygienist
- Spring Lake, NC
National Provider Identifier
1487748471
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 4623
- Practice address
- 103 Superior Drive
Spring Lake, NC 28390 - Phone
- (910) 497-3200
- Fax
- (910) 497-2209
- NPI assigned
- Oct 3, 2006
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Dental Hygienist | 124Q00000X | 4623 | NC | Primary |
Addresses
Primary practice location
103 Superior Drive
Spring Lake, NC 28390
Mailing address
150 Tram Rd
Spring Lake, NC 28390
Phone (910) 960-6266
Other names 1
- Ms. Tracey Perry
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 |
|---|---|---|---|
| 4623 | NC | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dr David G Dickerhoff DDS & Associates PA | 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.
-
- Dental Clinic/Center
- Spring Lake, NC
- NPI 1003992223
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159833600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1487748471",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "150 TRAM RD",
"city": "SPRING LAKE",
"state": "NC",
"postal_code": "28390",
"telephone_number": "910-960-6266"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "103 SUPERIOR DRIVE",
"city": "SPRING LAKE",
"state": "NC",
"postal_code": "28390",
"telephone_number": "910-497-3200",
"fax_number": "910-497-2209"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "TRACEY",
"middle_name": "PERRY",
"name_prefix": "Mrs.",
"credential": "RDH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "NC",
"license": "4623",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "TRACEY",
"last_name": "PERRY",
"prefix": "MS.",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Spring Lake, NC
Sources for this page
- 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.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.