Brian M Johnson, D.D.S. S.C.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1467G Issued in WI

Practice address

1838 Dunlap Ave
Marinette, WI 54143-1722

Phone

(715) 735-5626

Fax

(715) 735-3283

NPI assigned

Jan 16, 2007

Sex

Male

Sole proprietor

Yes

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.

• Johnson & Valenta Family Dentistry SC

  • General Practice Dentistry
  • Marinette, WI
  • NPI 1861728339
  NPD (past)

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1831241538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1838 DUNLAP AVE",
            "address_2": "PO BOX 480",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541431722",
            "telephone_number": "715-735-5626",
            "fax_number": "715-735-3283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1838 DUNLAP AVE",
            "city": "MARINETTE",
            "state": "WI",
            "postal_code": "541431722",
            "telephone_number": "715-735-5626",
            "fax_number": "715-735-3283"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRIAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S. S.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WI",
            "license": "1467G",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33504900",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeanne Dixon Counseling Services
• Jordan Jensen
• JMK Sales LLC
• John P Briody MD SC
• Johnson & Valenta Family Dentistry SC
• Karen Sue Johnson, LMT
• Dan Johnston
• Jacqueline Joan Johnston, 112561-30
• Ashley Jones, FNP-C
• Shannon E. Jones, BSN-RN, NCSN

• General Practice Dentistry in Marinette, WI
• Providers in Marinette, WI by specialty
• General Practice Dentistry in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.