NPIMap

Organization Active NPI

Bryan C Johnson DMD PC

Doing business as Lewis River Dental

  • Dental Clinic/Center
  • Woodland, WA
National Provider Identifier
1962717520
Registry record updated Aug 6, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
License
8734 Issued in WA
Legal business name
BRYAN C JOHNSON DMD PC
Doing business as
Lewis River Dental
Practice address
500 Columbia St
Suite B
Woodland, WA 98674-8491
Phone
(360) 225-5600
Fax
(360) 225-0369
NPI assigned
Aug 6, 2010
Last updated
Aug 6, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2010

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

Authorized official

Name
Dr. Bryan Carl Johnson, DMDNPI 1326167396
Title
Owner
Phone
(360) 225-5600

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 8734 WA Primary

Addresses

Primary practice location

500 Columbia St
Suite B
Woodland, WA 98674-8491

Mailing address

500 Columbia St
Suite B
Woodland, WA 98674-8491
Phone (360) 225-5600

Other names 1

  • Lewis River Dental Doing business as

National Provider Directory

National Provider Directory

Locations

500 Columbia St
Ste B
Woodland, WA 98674
Phone (360) 225-5600

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1281052800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1281052800000",
    "number": "1962717520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 COLUMBIA ST",
            "address_2": "SUITE B",
            "city": "WOODLAND",
            "state": "WA",
            "postal_code": "986748491",
            "telephone_number": "360-225-5600",
            "fax_number": "360-225-0369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 COLUMBIA ST",
            "address_2": "SUITE B",
            "city": "WOODLAND",
            "state": "WA",
            "postal_code": "986748491",
            "telephone_number": "360-225-5600",
            "fax_number": "360-225-0369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRYAN C JOHNSON DMD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-08-06",
        "last_updated": "2010-08-06",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_middle_name": "CARL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-225-5600",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DMD"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "WA",
            "license": "8734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lewis River Dental",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.

Verify at the official NPI Registry.