Bruce W Johnson, D.M.D.

Primary specialty

PeriodonticsTaxonomy code 1223P0300X

License

29312 Issued in CA

Practice address

15708 Pomerado Rd Ste N104
Poway, CA 92064

Phone

(858) 485-1180

Fax

(858) 485-1426

NPI assigned

Jul 17, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Bruce W. Johnson, D.M.D., Apdc

  • Periodontics
  • Poway, CA
  • NPI 1376766345
  NPD (past) Authorized official
• Travis Steinberg DDS Inc.

  • Dental Clinic/Center
  • Poway, CA
  • NPI 1770211971
  NPD (past)

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526947200000",
    "number": "1497773485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 270769",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921982769",
            "telephone_number": "858-485-1180",
            "fax_number": "858-485-1426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15708 POMERADO RD STE N104",
            "city": "POWAY",
            "state": "CA",
            "postal_code": "92064",
            "telephone_number": "858-485-1180",
            "fax_number": "858-485-1426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRUCE",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2018-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223P0300X",
            "taxonomy_group": "",
            "desc": "Dentist, Periodontics",
            "state": "CA",
            "license": "29312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jinhyun Cho, D.D.S., Inc.
• Jodi a McGrady DMD, Ms, Adc (McGrady Dental Group)
• Joseph Johanek, RPH
• An Lee Johnson
• Ashley Johnson
• Gracee-Ann Behavior Johnson
• Patricia Johnson, MD
• Suzanne Christine Johnston, D.O
• Anaya Jones
• Jonah Jones

• Periodontics in Poway, CA
• Providers in Poway, CA by specialty
• Periodontics in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.