Lauris Wallace Johnson, DMD

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DN16876 Issued in FL

Practice address

3621 Vinings Slope SE
3309
Atlanta, GA 30339-4107

Phone

(770) 235-7618

NPI assigned

Nov 27, 2007

Last updated

Apr 3, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

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

{
    "created_epoch": "1196121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1333411200000",
    "number": "1558543066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3621 VININGS SLOPE SE",
            "address_2": "3309",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303394107",
            "telephone_number": "770-235-7618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3621 VININGS SLOPE SE",
            "address_2": "3309",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303394107",
            "telephone_number": "770-235-7618"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LAURIS",
        "middle_name": "WALLACE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-27",
        "last_updated": "2012-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "FL",
            "license": "DN16876",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latrica M Johnson, RDH
• Laura Sabine Johnson, MD
• Lauren Johnson
• Lauren Alexis Johnson
• Laurie Johnson, LAPC
• Lauryn Denise Johnson
• Lawana R Johnson, NP
• Lindsay Danielle Johnson, NP
• Lingeela La'Isa Johnson, PHD
• Lionel Terry Johnson, OPERATIONS

• Orthodontics and Dentofacial Orthopedics Dentistry in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2012; 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.