TRACY R JOHNSON (NPI# 1548241219) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1548241219 |
| Entity Type | Individual |
| Full Name | TRACY R JOHNSON |
| Credential | DDS |
| Practice Address |
9101 Bridgeport Way Sw Bldg B2 Lakewood WA 98499-2419 |
| Practice Telephone | 2535840858 |
| Practice Fax Number | 2535841446 |
| Mailing Telephone | 2535840858 |
| Mailing Fax Number | 2535841446 |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2013-04-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
13638 | TX | Dental Providers |
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
DE00008961 | WA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760980734 | Tracy Johnson | Behavioral Analyst | 8200 Haven Ave Apt 7211, Rancho Cucamonga, CA 91730-6972 | 2018-01-25 |
| 1588052419 | Tracy Johnson | Licensed Practical Nurse | 85 Floss Ave, Buffalo, NY 14211-1901 | 2014-12-30 |
| 1447665138 | Tracy Johnson | Registered Nurse | 120 Danville Dr, Leesburg, GA 31763-5706 | 2014-06-22 |
| 1255692638 | Tracy Darnelle Johnson | Registered Nurse | 985 Irvin Shoots Rd E, Marion, OH 43302-9739 | 2012-06-01 |
| 1194029520 | Tracy L Johnson | Registered Nurse | 709 Mulberry Dr W, West Bend, WI 53090-2257 | 2010-12-28 |
| 1992938757 | Tracy Lynn Johnson | Prosthetic/Orthotic Supplier | 2309 S 17th St Ste 100, Wilmington, NC 28401-8006 | 2009-08-27 |
| 1568665578 | Tracy Ann Johnson | Counselor | 7420 Better Way Se, Snoqualmie, WA 99065 | 2007-06-07 |
| 1134322324 | Tracy L. Johnson | Speech-Language Pathologist | 2700 Feather Run Trl, Apt. E20, West Columbia, SC 29169-4966 | 2007-06-06 |
| 1891902433 | Tracy Lynne Johnson | Physical Therapy Assistant | 887 Lincoln Dr, Conneaut, OH 44030-2135 | 2007-05-16 |
| 1942343520 | Tracy Ann Johnson | Counselor | 5726 Marlin Road. Suite 200, Chattanooga, TN 37411 | 2007-02-14 |
| Street Address |
9101 BRIDGEPORT WAY SW BLDG B2 |
| City | LAKEWOOD |
| State | WA |
| Zip Code | 98499-2419 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275520405 | Michelle Marie Hayes | Nurse Practitioner | 9101 Bridgeport Way Sw, Suite A, Lakewood, WA 98499 | 2005-10-03 |
| 1710362975 | Daniel and Anna Spencer, Dmd, Ps | Durable Medical Equipment & Medical Supplies | 9101 Bridgeport Way Sw, Suite B1, Lakewood, WA 98499 | 2015-07-29 |
| 1235517541 | Bridgeport Family Vision Clinic, Pllc | Optometrist | 9101 Bridgeport Way Sw, Suite C, Lakewood, WA 98499-2419 | 2015-05-07 |
| 1851532659 | Fir Creek Pediatrics | Clinic/Center | 9101 Bridgeport Way Sw, Bld A, Lakewood, WA 98499-2419 | 2009-03-09 |
| 1508043019 | David Thomas Williams | Optometrist | 9101 Bridgeport Way Sw, Lakewood, WA 98499 | 2008-01-28 |
| 1609900638 | David A Cotant Dds Ps | Dentist | 9101 Bridgeport Way Sw, Bldg B2, Lakewood, WA 98499-2419 | 2007-03-14 |
| 1689708620 | David A Cotant | Dentist | 9101 Bridgeport Way Sw, Suite B2, Lakewood, WA 98499-2419 | 2007-03-14 |
| 1013043777 | David Y Park | Dentist | 9101 Bridgeport Way Sw, Ste A, Lakewood, WA 98499 | 2007-02-26 |
| 1518970912 | Andrew Henry Leavitt | Dentist | 9101 Bridgeport Way Sw, Suite D, Lakewood, WA 98499-2419 | 2006-08-15 |
| 1144233743 | David Thomas Williams | Optometrist | 9101 Bridgeport Way Sw, Lakewood, WA 98499 | 2006-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275159592 | Sea Mar Community Health Centers | Clinic/Center | 5700 100th Street Se, Suite 510, Lakewood, WA 98499 | 2020-06-23 |
| 1568018828 | Heather Leigh Andrade | Behavioral Analyst | 6210 75th St W Ste 100, Lakewood, WA 98499 | 2019-08-13 |
| 1043870876 | Seoul Chinese Herbs Inc | Acupuncturist | 8705 S. Tacoma Way, Lakewood, WA 98499 | 2019-06-14 |
| 1013572064 | Puget Sound Kidney Centers | Clinic/Center | 11950 47th Ave Sw, Lakewood, WA 98499 | 2019-05-06 |
| 1447736657 | Marcela Cunan | Counselor | 9330 59th Avenue Southest, Lakewood, WA 98499 | 2018-07-11 |
| 1609382381 | Leroy Moore IIi | Counselor | 8811 S. Tacoma Way, 106, Lakewood, WA 98499 | 2017-12-18 |
| 1578077657 | Andrea Gaston | Behavior Technician | 8815 S. Tacoma Way, Suite 122, Lakewood, WA 98499 | 2017-11-27 |
| 1609389931 | Jennifer King | Social Worker | 5900 100th St Sw Ste 17b, Lakewood, WA 98499 | 2017-11-08 |
| 1750806337 | Wonyoung Lee | Counselor | 8811 South Tacoma Way, Suite 106, Lakewood, WA 98499 | 2017-08-04 |
| 1043749443 | Frederick Paltron Edwards | Counselor | 9500 Front Street, Suite 100, Lakewood, WA 98499 | 2017-06-08 |
| Find all providers in zip 98499 | ||||
| Taxonomy Code | 1223S0112X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Oral and Maxillofacial Surgery |
| The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194865907 | David William Todd | Dentist | 120 Southwestern Dr, Lakewood, NY 14750 | 2007-02-08 |
| 1972606903 | Nicholas C Diamantis | Dentist | 14700 Detroit Ave, Lakewood, OH 44107 | 2006-09-06 |
| 1407885601 | Urban Michael Picard | Dentist | 15711 Madison Ave Ste 104, Lakewood, OH 44107-5655 | 2006-07-01 |
| 1730156126 | Joseph C Piotrowski | Dentist | 400 Madison Ave, Lakewood, NJ 08701-3214 | 2006-03-03 |
| 1083153985 | Cle Oms Lakewood/rocky River - Jeffrey W. Kosman Dds Inc. | Dentist | 15711 Madison Ave, Suite 104, Lakewood, OH 44107-5655 | 2017-02-13 |
| 1144561002 | Brian K. Smith, D.d.s., M.d., Inc. | Dentist | 14701 Detroit Ave, Suite 333, Lakewood, OH 44107-4109 | 2013-03-01 |
| 1881946309 | Peak Oral & Maxillofacial Surgery Center | Dentist | 2290 Kipling St, Suite 2, Lakewood, CO 80215-1578 | 2012-10-08 |
| 1619104015 | Shore Oral Maxillo Surgery Group Pa | Dentist | 301 Madison Ave, Lakewood, NJ 08701-3266 | 2009-06-12 |
| 1821256504 | Haeman Noori | Dentist | 2290 Kipling St, Suite 2, Lakewood, CO 80215-1578 | 2008-05-29 |
| 1356567606 | Urban M. Picard Dds, Inc | Dentist | 15711 Madison Ave, Suite #104, Lakewood, OH 44107-5655 | 2007-04-17 |
| Find all providers in LAKEWOOD | ||||
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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.