Individual provider Active NPI

Brett Arthur Johnson, DDS, MS

  • Orthodontics and Dentofacial Orthopedics Dentistry
  • Wichita Falls, TX
National Provider Identifier
1942397765
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X
License
15998 Issued in TX
Practice address
2663 Plaza Parkway
Wichita Falls, TX 76308
Phone
(940) 691-9504
Fax
(940) 691-9530
NPI assigned
Oct 5, 2006
Sex
Male
Sole proprietor
Yes

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 15998 TX Primary

Addresses

Primary practice location

2663 Plaza Parkway
Wichita Falls, TX 76308

Mailing address

2663 Plaza Parkway
Wichita Falls, TX 76308
Phone (940) 691-9504

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20150709000566 CA Order and Referring Only - DentistPractitioner - Dentist 4587976261

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
15998TXMDAddiction (Substance Use Disorder) Counselor

NPI Registry JSON

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942397765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2663 PLAZA PARKWAY",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "76308",
            "telephone_number": "940-691-9504",
            "fax_number": "940-691-9530"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2663 PLAZA PARKWAY",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "76308",
            "telephone_number": "940-691-9504",
            "fax_number": "940-691-9530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRETT",
        "middle_name": "ARTHUR",
        "name_prefix": "Dr.",
        "credential": "DDS,  MS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "TX",
            "license": "15998",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita Falls, TX

Sources for this page

Verify at the official NPI Registry.