NPIMap

Organization Active NPI

Stacy D Johnson, DDS, PC

  • Dental Clinic/Center
  • Greenwood, IN
National Provider Identifier
1982205415
Registry record updated Nov 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dental Clinic/CenterTaxonomy code 261QD0000X
Legal business name
STACY D JOHNSON, DDS, PC
Practice address
3056 W Stones Crossing Rd
Greenwood, IN 46143-6484
Phone
(317) 535-7141
NPI assigned
Nov 2, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2020

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

Authorized official

Name
Dr. Stacy Duane Johnson, DDS
Title
President
Phone
(317) 535-7141

Specialties & licenses 1

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

Addresses

Primary practice location

3056 W Stones Crossing Rd
Greenwood, IN 46143-6484

Mailing address

3056 W Stones Crossing Rd
Greenwood, IN 46143-6484
Phone (317) 535-7141

National Provider Directory

National Provider Directory

Locations

3056 W Stones Crossing Rd
Greenwood, IN 46143
Phone (317) 535-7141

Ownership & related parties

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

NPI Registry JSON

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

{
    "created_epoch": "1604275200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1604275200000",
    "number": "1982205415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3056 W STONES CROSSING RD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461436484",
            "telephone_number": "317-535-7141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3056 W STONES CROSSING RD",
            "city": "GREENWOOD",
            "state": "IN",
            "postal_code": "461436484",
            "telephone_number": "317-535-7141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STACY D JOHNSON, DDS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-02",
        "last_updated": "2020-11-02",
        "certification_date": "2020-10-29",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "DUANE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "317-535-7141",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DDS"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenwood, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2020; 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.