JOHNSON FAMILY DENTISTRY (NPI# 1073124103) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1073124103 |
| Entity Type | Organization |
| Organization Name | JOHNSON FAMILY DENTISTRY |
| Practice Address |
1617 E Milham Ave Portage MI 49002-3049 |
| Practice Telephone | 2693817250 |
| Practice Fax Number | 2693817260 |
| Mailing Telephone | 2693817250 |
| Enumeration Date | 2020-08-12 |
| Last Update Date | 2020-08-12 |
| Authorized Official Name | STACIA GRZIBOWSKI (OFFICE MANAGER) |
| Authorized Official Telephone | 2693817250 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223G0001X |
Dentist Specialization: General Practice |
Dental Providers |
| Other Name | Type Code |
|---|---|
| johnson family dentistry | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912291352 | Johnson Family Dentistry | Dentist | 4297 Ben Hill Rd, Atlanta, GA 30349-2025 | 2011-06-02 |
| 1255752614 | Johnson Family Dentistry | Dentist | 722 Harvard Dr, Owensboro, KY 42301-6152 | 2014-01-02 |
| 1538346424 | Johnson Family Dentistry | Dentist | 1951 S Alafaya Trl, Orlando, FL 32828-8732 | 2008-01-23 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Johnson Family Dentistry, P.C. | 25 South Lot Avenue, Montrose, CO 81401 |
| Street Address |
1617 E MILHAM AVE |
| City | PORTAGE |
| State | MI |
| Zip Code | 49002-3049 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164642906 | West Wind Family &cosmetic Denistry | Dentist | 1617 E Milham Ave, Portage, MI 49002-3049 | 2007-04-26 |
| 1639605215 | Lauren Schultz | Behavior Technician | 1617 E Milham Ave, Suite B, Portage, MI 49002-3049 | 2017-05-03 |
| 1164957148 | Patrick Ducey | Behavior Technician | 1617 E Milham Ave, Suite B, Portage, MI 49002-3049 | 2017-04-27 |
| 1801321997 | Lindie Mckenzie | Behavior Technician | 1617 E Milham Ave, Suite B, Portage, MI 49002-3049 | 2017-04-26 |
| 1447784491 | Robert Sarker | Behavior Technician | 1617 E Milham Ave, Suite B, Portage, MI 49002-3049 | 2017-04-17 |
| 1225562507 | Erin O'brien | Behavior Technician | 1617 E Milham Ave, Portage, MI 49002-3049 | 2017-04-13 |
| 1326572686 | Jacob Savage | Behavior Technician | 1617 E Milham Ave, Portage, MI 49002-3049 | 2017-04-13 |
| 1073047320 | Naomi Breiler | Behavior Technician | 1617 E Milham Ave, Suite B, Portage, MI 49002-3049 | 2017-04-13 |
| 1265966519 | Patrick Wieszciecinski | Behavioral Analyst | 1617 E Milham Ave, Suite B, Portage, MI 49002-3049 | 2017-04-13 |
| 1073047338 | Julie Everts | Behavior Technician | 1617 E Milham Ave, Portage, MI 49002-3049 | 2017-04-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932604204 | Susan Vandewalker | Physical Therapist | 8001 Angling Rd., Portage, MI 49002 | 2018-03-28 |
| 1134634934 | Portage Chiropractic and Wellness Center | Chiropractor | 609 E. Centre, Portage, MI 49002 | 2017-12-04 |
| 1548620537 | Patricia Eid | Behavioral Analyst | 1016 E Milham Ave, Suite 2, Portage, MI 49002 | 2016-03-03 |
| 1386045383 | Pinnacle Senior Care of Kalamazoo, LLC | Home Health | 2725 Airview Blvd Ste 105b, Portage, MI 49002 | 2014-09-09 |
| 1104241611 | Meredith Ayers Holland | Behavioral Analyst | 9616 Portage Road, Portage, MI 49002 | 2014-02-20 |
| 1619211919 | Daketia L Thomas | Massage Therapist | 8314 Portage Rd, Suite D, Kalamazoo, MI 49002 | 2012-11-27 |
| 1831457142 | Kinetic Kids, LLC | Occupational Therapist | 540 East Milham, Portage, MI 49002 | 2012-04-25 |
| 1154689404 | Lauren Michelle Mattaliano | Occupational Therapist | 540 E. Milham Road, Portage, MI 49002 | 2012-04-24 |
| 1114219227 | South Michigan Psychiatric Services LLC | Psychiatry & Neurology | 5390 Lovers Ln, Third Floor, Portage, MI 49002 | 2011-05-07 |
| 1174836316 | Premier Neuropsychiatry Plc | Psychiatry & Neurology | 5930 Lovers Lane, Portage, MI 49002 | 2010-07-16 |
| Find all providers in zip 49002 | ||||
| Taxonomy Code | 1223G0001X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | General Practice |
| A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. |
| Notes: Source: Academy of General Dentistry |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225696248 | Christopher J Fronczak | Dentist | 8080 Moorsbridge Rd Ste 101, Portage, MI 49024-4422 | 2019-06-04 |
| 1306308515 | Healthy Smiles Portage, LLC | Dentist | 6280 W Main St, Portage, IN 46368-4670 | 2019-04-05 |
| 1093281149 | Secure Dental Vii | Dentist | 6129 Us Highway 6, Portage, IN 46368-5058 | 2018-10-16 |
| 1952821837 | Adalene Marie Chabon | Dentist | 8150 Moorsbridge Rd Ste A, Portage, MI 49024-7419 | 2017-06-22 |
| 1366848509 | Seubert Family Dentistry, LLC | Dentist | 260 W. Cook St., Portage, WI 53901-2106 | 2014-11-17 |
| 1265690044 | Joseph Michael Labella | Dentist | 1508 New Pinery Rd, Portage, WI 53901-1312 | 2008-05-28 |
| 1295930196 | Bewick Dental Corp | Dentist | 3410 Willowcreek Rd, Portage, IN 46368-5089 | 2007-06-19 |
| 1548462526 | Nicas Yiannias | Dentist | 5943 Central Ave, Portage, IN 46368-2946 | 2007-06-01 |
| 1164642906 | West Wind Family &cosmetic Denistry | Dentist | 1617 E Milham Ave, Portage, MI 49002-3049 | 2007-04-26 |
| 1699802280 | Frank Michael Walerko | Dentist | 6060 Lute Rd, Portage, IN 46368-5008 | 2007-02-28 |
| Find all providers in PORTAGE | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.