Active NPI
Marc Levi Johnson, DMD
- Dentist
- Robinson, TX
National Provider Identifier
1609498385
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 36306
- Practice address
- 421 N Robinson Dr
Robinson, TX 76706-5303 - Phone
- (254) 662-3306
- NPI assigned
- May 15, 2020
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Dentist | 122300000X | 36306 | TX | Primary |
Addresses
Primary practice location
421 N Robinson Dr
Robinson, TX 76706-5303
Mailing address
2661 E Diamond Ave
Mesa, AZ 85204-3846
Phone (480) 735-1842
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 |
|---|---|---|---|
| 36306 | TX | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Progressive Dental Center PC | Dentist | 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.
-
- Dentist
- Waco, TX
- NPI 1295839884
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633478400000",
"number": "1609498385",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2661 E DIAMOND AVE",
"city": "MESA",
"state": "AZ",
"postal_code": "852043846",
"telephone_number": "480-735-1842"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "421 N ROBINSON DR",
"city": "ROBINSON",
"state": "TX",
"postal_code": "767065303",
"telephone_number": "254-662-3306"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "MARC",
"middle_name": "LEVI",
"name_prefix": "Dr.",
"credential": "DMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2020-05-15",
"last_updated": "2021-10-06",
"certification_date": "2021-10-06",
"status": "A"
},
"taxonomies": [
{
"code": "122300000X",
"taxonomy_group": "",
"desc": "Dentist",
"state": "TX",
"license": "36306",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Robinson, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.