Richard C Johnson, L.D.

Primary specialty

DenturistTaxonomy code 122400000X

License

416 Issued in WA

Practice address

3720 6TH Ave
Ste a
Tacoma, WA 98406-4938

Phone

(253) 752-1320

Fax

(253) 752-1425

NPI assigned

May 22, 2007

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.

• Olympic Dental & Denture Center, LLC

  • Dental Clinic/Center
  • Tacoma, WA
  • NPI 1003148719
  NPD (past) Authorized official
• Olympic Dental & Denture Center,LLC

  • Dental Clinic/Center
  • Tacoma, WA
  • NPI 1750409827
  NPD (past) Authorized official

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1679782973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3720 6TH AVE",
            "address_2": "STE A",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984064938",
            "telephone_number": "253-752-1320",
            "fax_number": "253-752-1425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3720 6TH AVE",
            "address_2": "STE A",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984064938",
            "telephone_number": "253-752-1320",
            "fax_number": "253-752-1425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RICHARD",
        "middle_name": "C",
        "credential": "L.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122400000X",
            "taxonomy_group": "",
            "desc": "Denturist",
            "state": "WA",
            "license": "416",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5042817",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Randolph Wilson Johnson, MSW/DCSW
• Raynai Johnson, LICSW
• Rebecca H Johnson, MD
• Rene Lawrence Johnson, PA-C
• Renee Marie Johnson, LMFTA
• Roberta Lynn Johnson, LPN
• Robyn Lynn Johnson, LMP
• Safia Kassam Johnson, N.D.
• Sarah Johnson, RN
• Shawn M Johnson

• Denturist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Denturist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.