Heenan Johnson III, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

15727 Issued in TX

Practice address

2204 Ithaca Ave
Lubbock, TX 79410-3206

Phone

(806) 793-4438

NPI assigned

Feb 14, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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 TX

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": "1139875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1952375446",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2204 ITHACA AVE",
            "address_2": "SUITE B",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794101300",
            "telephone_number": "806-793-4438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2204 ITHACA AVE",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794103206",
            "telephone_number": "806-793-4438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "HEENAN",
        "name_suffix": "III",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-14",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "TX",
            "license": "15727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Detra Johnson, RN
• Elise Michella Johnson, PHARM D.
• Erin Ruth Johnson, OT
• Esther Yvonne Johnson, MD
• Heather Johnson, PHARMD
• Jackie Jerome Johnson Sr., LCDC-I
• Jake Johnson, CRNA
• James Matthew Johnson, D.C.
• John Cameron Johnson, DDS
• Joseph Henry Johnson

• Dentist in Lubbock, TX
• Providers in Lubbock, TX by specialty
• Dentist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.