Michael Walter Johnson, M.D. & DDS

Primary specialty

Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X

License

36335 Issued in CO

Practice address

72 Suttle St
S# E
Durango, CO 81303-6829

Phone

(970) 385-5432

Fax

(970) 385-5077

NPI assigned

Jul 17, 2006

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)

Enrolled

Credentials

Doctor of Medicine

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.

• Four Corners Oral and Maxilliofacial Surgery

  • Dental Clinic/Center
  • Durango, CO
  • NPI 1104162452
  NPD (past) Authorized official

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765411200000",
    "number": "1811914344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "72 SUTTLE ST",
            "address_2": "S# E",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813036829",
            "telephone_number": "970-385-5432",
            "fax_number": "970-385-5077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "72 SUTTLE ST",
            "address_2": "S# E",
            "city": "DURANGO",
            "state": "CO",
            "postal_code": "813036829",
            "telephone_number": "970-385-5432",
            "fax_number": "970-385-5077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHAEL",
        "middle_name": "WALTER",
        "name_prefix": "Dr.",
        "credential": "M.D. & DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2025-12-11",
        "certification_date": "2025-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "CO",
            "license": "36335",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Marie Johnson Pace, LCSW
• Bradley Todd Johnson
• Jay C Johnson, M.D.
• Jordan Johnson, AUD.
• Meghan B Johnson
• Shera Michelle Johnson, MT
• Stephen Mackemer Johnson
• Vaughn Andrew Johnson, DDS, MS
• Juilene Helen Johnston, D.C.
• Wayne Andrew Johnston, CRNA

• Oral and Maxillofacial Surgery (Dentist) in Durango, CO
• Providers in Durango, CO by specialty
• Oral and Maxillofacial Surgery (Dentist) in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 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.