LARRY A JOHNSON DDS PC (NPI# 1437247889) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1437247889 |
| Entity Type | Organization |
| Organization Name | LARRY A JOHNSON DDS PC |
| Practice Address |
69 Hall Road Sturbridge MA 01566 |
| Practice Telephone | 5083472673 |
| Practice Fax Number | 5083475085 |
| Mailing Telephone | 5083472673 |
| Mailing Fax Number | 5083475085 |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. LARRY A JOHNSON (PERIODENTIST) |
| Authorized Official Telephone | 5083472673 |
| Authorized Official Credential | DDS |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
12356 | MA | Dental Providers |
| Street Address |
69 HALL ROAD |
| City | STURBRIDGE |
| State | MA |
| Zip Code | 01566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811147598 | Larry A Johnson | Dentist | 69 Hall Road, Sturbridge, MA 07566 | 2008-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609368919 | Martha Charley | Nurse Practitioner | Southbridge Pain Clinic, 48 Main Street Suite 6, Sturbridge, MA 01566 | 2018-06-01 |
| 1013407097 | Jolynn Klier | Psychologist | 1 Library Ln N, Sturbridge, MA 01566 | 2018-05-15 |
| 1841703295 | Brandon A Campo | Behavioral Analyst | 54 Main St Unit 0, Sturbridge, MA 01566 | 2017-11-08 |
| 1023407145 | Village Family Chiropractic, LLC | Chiropractor | 58 Main Street, Sturbridge, MA 01566 | 2015-01-13 |
| 1013330166 | Debra Kizilcan | Massage Therapist | 426 Main Street C/o Alternatives for Health, Sturbridge, MA 01566 | 2014-01-27 |
| 1124453659 | Gennady Gelman | Family Medicine | 198 Charlton Rd, Sturbridge, MA 01566 | 2013-09-03 |
| 1710123492 | Heritage Home Health Care, LLC | Home Health | 559 Main Street, Suite 103, Sturbridge, MA 01566 | 2008-12-30 |
| 1225176373 | William Brian Digregorio | Chiropractor | 64 Main St Rt 131, Sturbridge, MA 01566 | 2007-02-01 |
| 1639281090 | Mohamed Hashi Abib | Family Medicine | 128 Main St Ste 4, Sturbridge, MA 01566 | 2006-08-31 |
| 1417965369 | Michael Charles Jedrzynski | Podiatrist | 118 Main St #4, Sturbridge, MA 01566 | 2006-08-04 |
| Find all providers in zip 01566 | ||||
| Taxonomy Code | 1223P0300X |
| Grouping | Dental Providers |
| Classification | Dentist |
| Specialization | Periodontics |
| That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structures and tissues. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811147598 | Larry A Johnson | Dentist | 69 Hall Road, Sturbridge, MA 07566 | 2008-09-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871134833 | Supontep Teerakanok | Dentist | Henry Goldman School of Dental Medicine, 635 Albany St, Boston, MA 02118 | 2019-10-01 |
| 1437700218 | Mansour Alasiri | Dentist | 650 Albany St Ste 341, Boston, MA 02118-2518 | 2019-09-24 |
| 1508417338 | Bushra Aljahdali | Dentist | 650 Albany St Fl 3, Boston, MA 02118-2518 | 2019-09-23 |
| 1164077152 | North Shore Smiles LLC | Dentist | 293 Humphrey Str., Swampscott, MA 01907 | 2019-08-06 |
| 1790330298 | Cambridge Periodontics LLC | Dentist | 1692 Massachusetts Ave Ste 3, Cambridge, MA 02138 | 2019-08-02 |
| 1043863533 | Ricardo Lazaro Pascual | Dentist | 1 Kneeland St Dept, Boston, MA 02111-1527 | 2019-07-23 |
| 1568014827 | David B Rosen Dmd | Dentist | 57 Bedford St Ste 110, Lexington, MA 02420-4550 | 2019-07-16 |
| 1396209961 | Gabriel Boustani Dmd PC | Dentist | 822 Boylston St Ste 200, Chestnut Hill, MA 02467-2504 | 2019-01-28 |
| 1568935153 | Periodontology Associates of Concord, Pllc | Dentist | 290 Baker Ave Ste 3, Concord, MA 01742-2189 | 2019-01-07 |
| 1467925057 | Periodontology Associates of Lexington, Pllc | Dentist | 35 Bedford St Ste 20, Lexington, MA 02420-4440 | 2019-01-07 |
| Find all providers with the same taxonomy | ||||
| City | STURBRIDGE |
| Zip Code | 01566 |
Please comment or provide details below to improve the information on LARRY A JOHNSON DDS PC.
| 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.