Gabrielle M Johnson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

12012168A Issued in IN

Practice address

2046 Dorchester CT
Goshen, IN 46526-6534

Phone

(574) 533-2469

Fax

(574) 537-1791

NPI assigned

Jun 19, 2014

Last updated

Dec 29, 2024By the provider in NPPES

Sex

Female

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

Enrolled in IN

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.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Breathe and Smile Studio LLC

  dba Gabrielle M. Johnson DDS

  • General Practice Dentistry
  • Goshen, IN
  • NPI 1114735669
  NPD Authorized official
• Willig Dentistry, PC

  dba Orange Door Dental Group of Warsaw

  • General Practice Dentistry
  • Warsaw, IN
  • NPI 1558639872
  NPD (past)

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

{
    "created_epoch": "1403136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735430400000",
    "number": "1871907725",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2046 DORCHESTER CT",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465266534",
            "telephone_number": "574-533-2469",
            "fax_number": "574-537-1791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2046 DORCHESTER CT",
            "city": "GOSHEN",
            "state": "IN",
            "postal_code": "465266534",
            "telephone_number": "574-533-2469",
            "fax_number": "574-537-1791"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "GABRIELLE",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-06-19",
        "last_updated": "2024-12-29",
        "certification_date": "2024-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "IN",
            "license": "12012168A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1871907725",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey P. Bolduan, M.D. Inc
• Jennifer Miller Counseling, PC
• Keith D Jodway, LMHC, LCAC
• Joel William Counseling LLC
• Rachel A Johns, C.N.M.
• Rebecca E Johnson, CNM
• Taylor Michelle Johnson
• Audra L Joldersma, M.S.CCC-SLP
• Daniel Paul Joldersma, DDS
• Jennifer Elizabeth Jones

• General Practice Dentistry in Goshen, IN
• Providers in Goshen, IN by specialty
• General Practice Dentistry in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.