Brandon Michael Johnson, D.M.D., M.S.D.

Primary specialty

Orthodontics and Dentofacial Orthopedics DentistryTaxonomy code 1223X0400X

License

DE60327979 Issued in WA

Practice address

37624 SE Fury St
Suite C220
Snoqualmie, WA 98065-9680

Phone

(425) 292-6162

Fax

(425) 292-6163

NPI assigned

Nov 12, 2010

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1289520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456272000000",
    "number": "1972804573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "37624 SE FURY ST",
            "address_2": "SUITE C220",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "980659680",
            "telephone_number": "425-292-6162",
            "fax_number": "425-292-6163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37624 SE FURY ST",
            "address_2": "SUITE C220",
            "city": "SNOQUALMIE",
            "state": "WA",
            "postal_code": "980659680",
            "telephone_number": "425-292-6162",
            "fax_number": "425-292-6163"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "BRANDON",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "D.M.D., M.S.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-11-12",
        "last_updated": "2016-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CO",
            "license": "10329",
            "primary": false
        },
        {
            "code": "1223X0400X",
            "taxonomy_group": "",
            "desc": "Dentist, Orthodontics and Dentofacial Orthopedics",
            "state": "WA",
            "license": "DE60327979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason Green, PLLC
• Jiulin Zhu PLLC
• Joanna Hagen Arnp PLLC
• John M. Gray, MD, PLLC
• Alan K Johnson, MD
• Julie Ann Johnson, L.M.P.
• Noel Theodore Johnson, D.O.
• Tracy Ann Johnson, MA, LMHC
• Anne Marie Jones, LMHCA
• Frank Jones

• All providers in Snoqualmie, WA
• Orthodontics and Dentofacial Orthopedics Dentistry in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2016; 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.