Nicole Johnson, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

30.024301 Issued in OH

Practice address

1600 W Lane Ave Unit 310
Upper Arlington, OH 43221-3966

Phone

(847) 401-0182

NPI assigned

Apr 23, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Nicole Johnson Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1398211200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690243200000",
    "number": "1740600105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 W LANE AVE UNIT 310",
            "city": "UPPER ARLINGTON",
            "state": "OH",
            "postal_code": "432213966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 W LANE AVE UNIT 310",
            "city": "UPPER ARLINGTON",
            "state": "OH",
            "postal_code": "432213966",
            "telephone_number": "847-401-0182"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1413 N Quentin Rd",
            "address_purpose": "LOCATION",
            "city": "Palatine",
            "state": "IL",
            "postal_code": "600672040",
            "country_code": "US",
            "telephone_number": "847-401-0182",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "NICOLE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-23",
        "last_updated": "2023-07-25",
        "certification_date": "2023-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "OH",
            "license": "30.024301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NICOLE",
            "last_name": "JOHNSON",
            "credential": "DDS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• James Schramm Chiropractic, Inc.
• Ryan D Jayne, PT
• Yichen Jiang, OT
• Cassandra L Johnson, PA-C
• Catherine A Johnson, CRNP
• Jones Neurology LTD
• Dana Jones, FNP-BC
• Daniel A. Jones, M.D.
• Kathleen Abels Jones, PT
• Teresa W Julian, R.N. FNP PH.D

• Pediatric Dentistry in Upper Arlington, OH
• Providers in Upper Arlington, OH by specialty
• Pediatric Dentistry in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2023; 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.