Active NPI
Doug Johnson
- General Practice Dentistry
- Iowa City, IA
National Provider Identifier
1639575855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- DDS-10255
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150921000604 | CA | Order and Referring Only - Dentist | 6800103045 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DDS-10255 | IA | MD | General Practice Dentistry |
| D14139 | MN | MD | General Practice Dentistry |
| 63908 | CA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sleep Innovations PLLC | Past | Accepting new patients | |
| William M. Dorfman D.D.S. | Past | Accepting new patients | |
| State University of Iowa | Past | 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.
-
- Family Nurse Practitioner
- Bettendorf, IA
- NPI 1730893835
-
- Clinical Medical Laboratory
- Coralville, IA
- NPI 1851371561
-
- Dental Clinic/Center
- Los Angeles, CA
- NPI 1386572030
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.