Bruce Alan Johnson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

DE00005444 Issued in WA

Practice address

7311 NE 141St St
Bothell, WA 98011-5303

Phone

(425) 823-4343

Fax

(425) 823-6735

NPI assigned

Oct 19, 2006

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

Medicare fee-for-service enrollment

Enrolled in WA

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

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932281946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7311 NE 141ST ST",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980115303",
            "telephone_number": "425-823-4343",
            "fax_number": "425-823-6735"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7311 NE 141ST ST",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980115303",
            "telephone_number": "425-823-4343",
            "fax_number": "425-823-6735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRUCE",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "WA",
            "license": "DE00005444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathy Johnsey, RN
• Alida Johnson, MA, LMHC
• Amanda Danielle Johnson, LMP
• Anne Johnson, DC
• Brittony Johnson, LMP
• Bryan Johnson
• David Lynn Johnson, RPH
• Erin Dawn Johnson, M.S.P.A./CCC-SLP
• Gerald Ralph Johnson, RPH
• Katherine Grace Johnson, SLP

• General Practice Dentistry in Bothell, WA
• Providers in Bothell, WA by specialty
• General Practice Dentistry in Washington

• 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.
• 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.