Brendan G. Johnson, D.D.S.

Primary specialty

SpecialistTaxonomy code 174400000X

License

3335-S229 Issued in NV

Practice address

6950 Smoke Ranch Rd.
Suite 200
Las Vegas, NV 89128

Phone

(702) 360-8918

Fax

(702) 360-2504

NPI assigned

Jun 23, 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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2013 through Apr 1, 2027

Medicare enrollment (NPD)

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.

• Omfs Surgery Center, LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Las Vegas, NV
  • NPI 1043573553
  NPD (past) Authorized official
• Holtzen & Johnson, LTD

  • Specialist
  • Las Vegas, NV
  • NPI 1447346226
  NPD (past)

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202688000000",
    "number": "1811923980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6950 SMOKE RANCH RD.",
            "address_2": "SUITE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89128",
            "telephone_number": "702-360-8918",
            "fax_number": "702-360-2504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6950 SMOKE RANCH RD.",
            "address_2": "SUITE 200",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89128",
            "telephone_number": "702-360-8918",
            "fax_number": "702-360-2504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRENDAN",
        "middle_name": "G.",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2008-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "NV",
            "license": "3335-S229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002202009",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Breanna Johnson
• Breanna Dasjinay Johnson
• Brenda Johnson
• Brenda Jo Johnson
• Brenda Shaye Johnson
• Bret Johnson
• Brezhane Johnson
• Brittney Megan Johnson
• Bryanna Josclyne Johnson
• Bryanna Nicole Johnson

• Specialist in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Specialist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.