David Alan Johnson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7599 Issued in IA

Practice address

3512 Jersey Ridge Rd
Davenport, IA 52807-2223

Phone

(536) 359-3494

Fax

(563) 355-8282

NPI assigned

Dec 14, 2006

Sex

Male

Sole proprietor

No

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)

Not enrolled

State licenses

Practice roles

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.

• Kimberly Park Dental Associates

  • Dentist
  • Davenport, IA
  • NPI 1689762494
  NPD (past)

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1669534087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3512 JERSEY RIDGE RD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072223",
            "telephone_number": "536-359-3494",
            "fax_number": "563-355-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3512 JERSEY RIDGE RD",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528072223",
            "telephone_number": "536-359-3494",
            "fax_number": "563-355-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DAVID",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IA",
            "license": "7599",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0096222",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John C Hubner DDS
• Johnson Chiropractic & Sports Injury, PC
• Alyssa Johnson
• Barbara J Johnson, LISW
• Bradley W Johnson, D.O
• Ellie Johnson
• Erin Johnson, CADC
• Gary Brian Johnson, MSW
• Gordon Ray Johnson, D.O.
• Julie L Johnson, D.C.

• General Practice Dentistry in Davenport, IA
• Providers in Davenport, IA by specialty
• General Practice Dentistry in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.