Daryl Lance Johnson, D.M.D.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2826-94 Issued in MS

Practice address

1313 W Highway 8
Cleveland, MS 38732-2240

Phone

(662) 843-8353

Fax

(662) 843-8303

NPI assigned

Aug 3, 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Dr Lance Johnson Family Dentistry

  • Dental Clinic/Center
  • Sherman, TX
  • NPI 1093313769
  NPD Authorized official
• Lifetime Dental LLC

  • Dentist
  • Greenwood, MS
  • NPI 1679024442
  NPD (past) Authorized official

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

{
    "created_epoch": "1154563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602633600000",
    "number": "1619985272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1313 W HIGHWAY 8",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387322240",
            "telephone_number": "662-843-8353",
            "fax_number": "662-843-8303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1313 W HIGHWAY 8",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387322240",
            "telephone_number": "662-843-8353",
            "fax_number": "662-843-8303"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "910 Medallion Dr",
            "address_purpose": "LOCATION",
            "city": "Greenwood",
            "state": "MS",
            "postal_code": "389302118",
            "country_code": "US",
            "telephone_number": "662-455-9149",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3333 N Fm 1417",
            "address_purpose": "LOCATION",
            "city": "Sherman",
            "state": "TX",
            "postal_code": "750923432",
            "country_code": "US",
            "telephone_number": "903-893-2540",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DARYL",
        "middle_name": "LANCE",
        "name_prefix": "Dr.",
        "credential": "D.M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-03",
        "last_updated": "2020-10-14",
        "certification_date": "2020-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MS",
            "license": "2826-94",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00660091",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Sherrill Jenkins, SLP
• Jason Matthew Jennings, DMD
• JLRL, LLC
• Brandi L Joel
• Clarence Johnson, CCC-SLP
• Christian Johnston
• Courtney Hong Johnston, PHARM D
• Christy G Jones, SLP
• Gerald Stephen Jordan Jr., ATC
• Joy Health & Rehab of Cleveland, LLC

• General Practice Dentistry in Cleveland, MS
• Providers in Cleveland, MS by specialty
• General Practice Dentistry in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.