David Bruce Johnson

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

1864 Issued in MT

Practice address

1125 W Kagy Blvd Ste 303
Bozeman, MT 59715-5879

Phone

(406) 587-2201

Fax

(406) 587-0880

NPI assigned

Dec 14, 2006

Last updated

Feb 16, 2017By the provider in NPPES

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)

Enrolled

State licenses

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487203200000",
    "number": "1851453120",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 W KAGY BLVD STE 303",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597155879",
            "telephone_number": "406-587-2201",
            "fax_number": "406-587-0880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 W KAGY BLVD STE 303",
            "city": "BOZEMAN",
            "state": "MT",
            "postal_code": "597155879",
            "telephone_number": "406-587-2201",
            "fax_number": "406-587-0880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "DAVID",
        "middle_name": "BRUCE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2017-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MT",
            "license": "1864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED CONCORDIA PROVIDER",
            "identifier": "091-576",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John a. Vallin, M.D., LLC
• John K H Griffith (Medical Arts Pharmacy)
• Ashley Johnson, LCSW
• Christene M Johnson, PAC
• Cynthia Ruth Johnson, OD
• Eric L Johnson, M.D.
• Jay Johnson
• Jeff T Johnson, LPC, LCPC
• Jennifer Anne Johnson, NP
• Jennifer L. Johnson, RD

• General Practice Dentistry in Bozeman, MT
• Providers in Bozeman, MT by specialty
• General Practice Dentistry in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2017; 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.