Dustin Daniel Roden-Johnson, DDS, MS

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

22109 Issued in TX

Practice address

301 Highway 71 W
Suite 201
Bastrop, TX 78602-4105

Phone

(512) 321-1000

NPI assigned

Oct 16, 2008

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Ski Town Orthodontics

  • Dental Clinic/Center
  • Glenwood Springs, CO
  • NPI 1356168553
  NPD Authorized official
• Ortho 360, LLP

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Bastrop, TX
  • NPI 1508084294
  NPD (past)

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

{
    "created_epoch": "1224115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1224115200000",
    "number": "1669624003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HWY 71 WEST",
            "address_2": "SUITE 201",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786024111",
            "telephone_number": "512-321-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HIGHWAY 71 W",
            "address_2": "SUITE 201",
            "city": "BASTROP",
            "state": "TX",
            "postal_code": "786024105",
            "telephone_number": "512-321-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RODEN-JOHNSON",
        "first_name": "DUSTIN",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "DDS, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-10-16",
        "last_updated": "2008-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "22109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leland Robertson
• Rockdale Blackhawk LLC
• Rockdale Blackhawk LLC
• Rockdale Blackhawk, LLC
• Rockdale Blackhawk, LLC
• April Elizabeth Rodgers, CPNP-PC
• Mariel Daniela Rodriguez
• Roberto Rodriguez, MA
• Romney Lassen Dental
• Brian Romney, DMD

• Orthodontics and Dentofacial Orthopedics Dentistry in Bastrop, TX
• Providers in Bastrop, TX by specialty
• Orthodontics and Dentofacial Orthopedics Dentistry in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2008; 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.