Active NPI
D. Todd Johnson DDS, PC
- Oral and Maxillofacial Surgery (Dentist)
- Broken Arrow, OK
National Provider Identifier
1912221052
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)
- License
- 5019
- Legal business name
- D. TODD JOHNSON DDS, PC
- Practice address
- 4716 W Urbana St
Broken Arrow, OK 74012-5997 - Phone
- (918) 449-5800
- Fax
- (918) 455-8958
- NPI assigned
- Mar 18, 2010
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Julia E Sams
- Title
- Contract Coordinator
- Phone
- (918) 449-5800
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Oral and Maxillofacial Surgery (Dentist) | 1223S0112X | 5019 | OK | Primary |
Addresses
Primary practice location
4716 W Urbana St
Broken Arrow, OK 74012-5997
Mailing address
4716 W Urbana St
Broken Arrow, OK 74012-5997
Phone (918) 449-5800
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100091300A | Medicaid | OK |
National Provider Directory
National Provider DirectoryLocations
12455 E 100th St N
Ste 240
Owasso, OK 74055
Phone (918) 274-0944
6132 E 61st St
Tulsa, OK 74136
Phone (918) 494-8634
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1268870400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1292803200000",
"number": "1912221052",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4716 W URBANA ST",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740125997",
"telephone_number": "918-449-5800",
"fax_number": "918-455-8958"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4716 W URBANA ST",
"city": "BROKEN ARROW",
"state": "OK",
"postal_code": "740125997",
"telephone_number": "918-449-5800",
"fax_number": "918-455-8958"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "D. TODD JOHNSON DDS, PC",
"organizational_subpart": "NO",
"enumeration_date": "2010-03-18",
"last_updated": "2010-12-20",
"status": "A",
"authorized_official_last_name": "SAMS",
"authorized_official_first_name": "JULIA",
"authorized_official_middle_name": "E",
"authorized_official_title_or_position": "CONTRACT COORDINATOR",
"authorized_official_telephone_number": "918-449-5800"
},
"taxonomies": [
{
"code": "1223S0112X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Dentist, Oral and Maxillofacial Surgery",
"state": "OK",
"license": "5019",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100091300A",
"state": "OK"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Broken Arrow, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.