Individual provider Active NPI

Michelle M Johnson, DDSMS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Bartlett, TN
National Provider Identifier
1891856274
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
DS0000004811 Issued in TN
Practice address
6551 Stage Oaks Dr
Suite 2
Bartlett, TN 38134-3895
Phone
(901) 386-5800
Fax
(901) 386-9604
NPI assigned
Dec 12, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthodontics and Dentofacial Orthopedics Dentistry 1223X0400X DS0000004811 TN Primary

Addresses

Primary practice location

6551 Stage Oaks Dr
Suite 2
Bartlett, TN 38134-3895

Mailing address

6551 Stage Oaks Dr
Suite 2
Bartlett, TN 38134-3895
Phone (901) 386-5800

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
DS0000004811TNMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Dental Tennessee PLLC Orthodontics and Dentofacial Orthopedics PastSince Jan 10, 2021 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1891856274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6551 STAGE OAKS DR",
            "address_2": "SUITE 2",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381343895",
            "telephone_number": "901-386-5800",
            "fax_number": "901-386-9604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6551 STAGE OAKS DR",
            "address_2": "SUITE 2",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381343895",
            "telephone_number": "901-386-5800",
            "fax_number": "901-386-9604"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MICHELLE",
        "middle_name": "M",
        "credential": "DDSMS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TN",
            "license": "DS0000004811",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlett, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.