Individual provider Active NPI

Chadwick Aaron Johnson, DDS

  • Dentist
  • Des Moines, IA
National Provider Identifier
1508978602
Registry record updated Mar 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
08353 Issued in IA
Practice address
3710 Merle Hay Road
Des Moines, IA 50310
Phone
(515) 255-5122
Fax
(515) 270-1646
NPI assigned
Aug 31, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 4, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 08353 IA
Dentist 122300000X 08353 IA Primary

Addresses

Primary practice location

3710 Merle Hay Road
Des Moines, IA 50310

Mailing address

PO Box 316
Williamsville, NY 14231
Phone (716) 204-4999

Other identifiers 4

IdentifierTypeStateIssuer
1771525OtherUNITED CONCORDIA
5082590017OtherMET LIFE
0462705MedicaidIA
137522OtherGUARDIAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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

Enrollment IDStateProvider typePAC IDDetails
I20151221001031 IA Practitioner - Oral Surgery 3072814839

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
08353IAMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Veranda Dentistry Johnston, PLC Current Accepting new patients
Allcare Dental & Dentures of Ia PC General Practice Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741046400000",
    "number": "1508978602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 316",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "14231",
            "telephone_number": "716-204-4999",
            "fax_number": "716-632-2963"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3710 MERLE HAY ROAD",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "50310",
            "telephone_number": "515-255-5122",
            "fax_number": "515-270-1646"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHADWICK",
        "middle_name": "AARON",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2025-03-04",
        "certification_date": "2025-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "08353",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "08353",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA",
            "identifier": "1771525",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MET LIFE",
            "identifier": "5082590017",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0462705",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GUARDIAN",
            "identifier": "137522",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Des Moines, IA

Sources for this page

Verify at the official NPI Registry.