Collis Johnson Jr., DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

04176 Issued in CO

Practice address

13065 E 17TH Ave
Aurora, CO 80045-2532

Phone

(303) 724-7073

NPI assigned

Sep 1, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

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": "1157068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630454400000",
    "number": "1831291855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1756 VINE STREET",
            "city": "DENVER",
            "state": "CO",
            "postal_code": "80206",
            "telephone_number": "303-322-1177",
            "fax_number": "303-322-1199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13065 E 17TH AVE",
            "city": "AURORA",
            "state": "CO",
            "postal_code": "800452532",
            "telephone_number": "303-724-7073"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "COLLIS",
        "name_suffix": "Jr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-01",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223E0200X",
            "taxonomy_group": "",
            "desc": "Dentist, Endodontics",
            "state": "CO",
            "license": "CO01476",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "CO",
            "license": "04176",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02014769",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bryce Johnson, PHARMD
• Candice Johnson, MD
• Casey Johnson
• Christine Johnson
• Colby S Johnson, D.C., M.S.N.
• Cornelius L Johnson
• Daniel C Johnson, M.D.
• Darlene S Johnson, M.D.
• David Thor Johnson, MD PHD
• Dayna Shannon Johnson, ACNPC-AG

• General Practice Dentistry in Aurora, CO
• Providers in Aurora, CO by specialty
• General Practice Dentistry in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; 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.