Logan D Johnson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

7934 Issued in NE

Practice address

12123 Pacific St
Omaha, NE 68154-3527

Phone

(402) 334-4422

NPI assigned

Jun 26, 2023

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

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.

• Classic Dentistry PC

  • General Practice Dentistry
  • Omaha, NE
  • NPI 1861505851
  NPD (past)

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

{
    "created_epoch": "1687737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687737600000",
    "number": "1811673676",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12123 PACIFIC ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681543527",
            "telephone_number": "402-334-4422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12123 PACIFIC ST",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681543527",
            "telephone_number": "402-334-4422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LOGAN",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-06-26",
        "last_updated": "2023-06-26",
        "certification_date": "2023-06-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "NE",
            "license": "7934",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsey R Johnson, APRN
• Lisa A Johnson
• Lisa Ann Johnson, APRN
• Lisa K Johnson, PHARM D
• Logan Johnson
• Lyndsay Johnson
• Lynette Johnson
• Madalyn Johnson
• Madonna Johnson
• Makenzie Kaylin Johnson

• General Practice Dentistry in Omaha, NE
• Providers in Omaha, NE by specialty
• General Practice Dentistry in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 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.