Individual provider Active NPI

Doug Johnson

  • General Practice Dentistry
  • Iowa City, IA
National Provider Identifier
1639575855
Registry record updated Oct 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DDS-10255 Issued in IA
Practice address
801 Newton Rd
Iowa City, IA 52242-8004
Phone
(319) 335-7499
NPI assigned
Nov 16, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 24, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X D14139 MN
General Practice Dentistry 1223G0001X DDS-10255 IA Primary
Dentist 122300000X 63908 CA

Addresses

Primary practice location

801 Newton Rd
Iowa City, IA 52242-8004

Mailing address

2920 Silver Oak TRL
Marion, IA 52302-9225
Phone (319) 360-8255

Other practice location 1

3290 Ridgeway Dr Ste 4
Coralville, IA 52241-2023
Phone (319) 626-2119

Other practice location 2

4048 Glass Rd NE
Cedar Rapids, IA 52402-2509
Phone (319) 220-5906

Other practice location 3

2882 AAA Ct
Bettendorf, IA 52722-3406
Phone (563) 341-7378

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20150921000604 CA Order and Referring Only - DentistPractitioner - Dentist 6800103045

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DDS-10255IAMDGeneral Practice Dentistry
D14139MNMDGeneral Practice Dentistry
63908CAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Sleep Innovations PLLC PastSince Jan 1, 2023 Accepting new patients
William M. Dorfman D.D.S. Past Accepting new patients
State University of Iowa PastSince Oct 27, 2024 Accepting new patients

Organizations & group practices 3

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": "1416096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761264000000",
    "number": "1639575855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2920 SILVER OAK TRL",
            "city": "MARION",
            "state": "IA",
            "postal_code": "523029225",
            "telephone_number": "319-360-8255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 NEWTON RD",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522428004",
            "telephone_number": "319-335-7499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3290 Ridgeway Dr Ste 4",
            "address_purpose": "LOCATION",
            "city": "Coralville",
            "state": "IA",
            "postal_code": "522412023",
            "country_code": "US",
            "telephone_number": "319-626-2119",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4048 Glass Rd NE",
            "address_purpose": "LOCATION",
            "city": "Cedar Rapids",
            "state": "IA",
            "postal_code": "524022509",
            "country_code": "US",
            "telephone_number": "319-220-5906",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2882 AAA Ct",
            "address_purpose": "LOCATION",
            "city": "Bettendorf",
            "state": "IA",
            "postal_code": "527223406",
            "country_code": "US",
            "telephone_number": "563-341-7378",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DOUG",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-11-16",
        "last_updated": "2025-10-24",
        "certification_date": "2025-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14139",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "DDS-10255",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "63908",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Iowa City, IA

Sources for this page

Verify at the official NPI Registry.