Active NPI
Chadwick Aaron Johnson, DDS
- Dentist
- Des Moines, IA
National Provider Identifier
1508978602
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 08353
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1771525 | Other | UNITED CONCORDIA | |
| 5082590017 | Other | MET LIFE | |
| 0462705 | Medicaid | IA | |
| 137522 | Other | GUARDIAN |
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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20151221001031 | IA | Practitioner - Oral Surgery | 3072814839 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08353 | IA | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Dental Clinic/Center
- Johnston, IA
- NPI 1881429108
-
- General Practice Dentistry
- Des Moines, IA
- NPI 1558538033
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2025; 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.