Individual provider Active NPI

Eric Allen Johnson, DDS

  • Dentist
  • San Antonio, TX
National Provider Identifier
1669586509
Registry record updated Aug 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
14075 Issued in TX
Practice address
13487 Blanco Rd
San Antonio, TX 78216-2132
Phone
(210) 492-0631
Fax
(210) 492-0510
NPI assigned
Aug 18, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 25, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X 14075 TX Primary

Addresses

Primary practice location

13487 Blanco Rd
San Antonio, TX 78216-2132

Mailing address

13487 Blanco Rd
San Antonio, TX 78216-2132
Phone (210) 492-0631

Other practice location 1

13205 George Rd
San Antonio, TX 78230-3018
Phone (210) 492-0205

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

LicenseStateTypeSpecialty
14075TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Dental Sa PC 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.

NPI Registry JSON

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

{
    "created_epoch": "1155859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1669586509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13487 BLANCO RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782162132",
            "telephone_number": "210-492-0631",
            "fax_number": "210-492-0510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13487 BLANCO RD",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782162132",
            "telephone_number": "210-492-0631",
            "fax_number": "210-492-0510"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13205 George Rd",
            "address_purpose": "LOCATION",
            "city": "San Antonio",
            "state": "TX",
            "postal_code": "782303018",
            "country_code": "US",
            "telephone_number": "210-492-0205",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ERIC",
        "middle_name": "ALLEN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-18",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "14075",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Antonio, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; 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.