DR. BRYAN J JOHNSON (NPI# 1740384981) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740384981 |
| Entity Type | Individual |
| Full Name | DR. BRYAN J JOHNSON |
| Credential | D.D.S. |
| Practice Address |
4250 Pontiac Lake Rd Suite B Waterford MI 48328-1281 |
| Mailing Address |
11525 Highland Rd Suite 23 Hartland MI 48353-2726 |
| Practice Telephone | 2486740303 |
| Practice Fax Number | 2486742947 |
| Mailing Telephone | 8106320303 |
| Mailing Fax Number | 8106327305 |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2014-06-27 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1223S0112X |
Dentist Specialization: Oral and Maxillofacial Surgery |
BJ017615 | MI | Dental Providers |
| N | 204E00000X | Oral & Maxillofacial Surgery | BJ017615 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | BCBS OF MI | 190F37120 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730743956 | Bryan A Johnson | Nurse Practitioner | 94-1221 Ka Uka Blvd # 108-166, Waipahu, HI 96797-6202 | 2019-04-23 |
| 1225508948 | Bryan Ann Johnson | Social Worker | 317 Arlington Rd, Hoyt Lakes, MN 55750-1117 | 2018-11-26 |
| 1164869921 | Bryan Andrew Johnson | Chiropractor | 414 Mcmurray Rd, Bethel Park, PA 15102-1132 | 2013-06-03 |
| 1356590855 | Bryan Manees Johnson | General Practice | Hhc 3 82 Gsab, Fort Bragg, NC 28310-0001 | 2008-09-09 |
| 1710199013 | Bryan Alan Johnson | Licensed Practical Nurse | 200 S Pettigrew St, Raleigh, NC 27610-2651 | 2007-05-07 |
| 1326167396 | Bryan Carl Johnson | Dentist | 500 Columbia St Ste B, Woodland, WA 98674-8491 | 2007-03-28 |
| 1891859112 | Bryan D. Johnson | Dentist | 516 Main St., Madison Lake, MN 56063 | 2006-12-21 |
| 1770573347 | Bryan Johnson | Dentist | 309 S Main St, Milbank, SD 57252-1810 | 2005-10-25 |
| 1023618501 | Bryan Karl Johnson | Pharmacist | 401 Supercenter Dr, Jefferson City, MO 65101-8190 | 2020-10-26 |
| 1174148308 | Bryan Douglas Johnson | Physical Therapist | 2501 Rice Lake Rd, Duluth, MN 55811-4819 | 2020-06-12 |
| Street Address |
4250 PONTIAC LAKE RD SUITE B |
| City | WATERFORD |
| State | MI |
| Zip Code | 48328-1281 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164753240 | John A Lazarus | Dentist | 4250 Pontiac Lake Rd, Suite A, Waterford, MI 48328-1281 | 2010-01-29 |
| 1568631489 | John A Lazarus Dds Ms PC | Dentist | 4250 Pontiac Lake Rd, Suite A, Waterford, MI 48328-1281 | 2008-02-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477184125 | Lillian Atty | Pharmacist | 1484 Rivona Dr, Waterford, MI 48328 | 2020-01-31 |
| 1437631850 | Rana Ismail | Pharmacist | 3273 West Huron St, Waterford, MI 48328 | 2018-09-01 |
| 1588181978 | India Dunlap | Social Worker | 279 Summit Dr., Waterford, MI 48328 | 2017-08-25 |
| 1689191280 | Sydney Strandberg | Social Worker | 1145 Parkway, Waterford, MI 48328 | 2017-08-24 |
| 1467982074 | Briana Greenlee | Dietitian, Registered | 3819 Faber Terrace, Waterford, MI 48328 | 2017-06-15 |
| 1922537364 | Lourdes Alzheimer's Special Care | Custodial Care Facility | 2400 Watkins Lake Rd, Waterford, MI 48328 | 2017-06-08 |
| 1013446459 | Lourdes Assisted Living | Assisted Living Facility | 2450 Watkins Lake Rd, Waterford, MI 48328 | 2017-06-08 |
| 1588019053 | Legacy Dermatology Group PC | Dermatology | 1392 S Cass Lake Rd, Waterford, MI 48328 | 2016-05-03 |
| 1932567989 | Devenia Denise Clayter | Counselor | 255 Summit Dr, Waterford, MI 48328 | 2016-02-05 |
| 1922409739 | Stacey Diggs | Counselor | 250 Elizabeth Lake Road, Biomed Behavorial Healthcare, Waterford, MI 48328 | 2014-09-11 |
| Find all providers in zip 48328 | ||||
| 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 |
|---|---|---|---|---|
| 1568080414 | Shawn J Kim | Dentist | 425 E Washington St Apt 811, Ann Arbor, MI 48104-2060 | 2020-07-08 |
| 1760008528 | Great Lakes Oral and Maxillofacial Surgery P.C. | Dentist | 2325 Summit Park Dr Ste D, Petoskey, MI 49770-8774 | 2020-06-17 |
| 1962969634 | Garfield Road Dental - 1 | Dentist | 41781 Garfield Rd, Clinton Township, MI 48038-1964 | 2019-02-28 |
| 1477903904 | Abed Yakan | Dentist | 2700 Martin Luther King Jr. Blvd., 358, Detroit, MI 48208-2576 | 2016-06-15 |
| 1811378508 | Christopher Niquette | Dentist | 2119 64th Street Sw, Byron Center, MI 49315-4931 | 2015-06-18 |
| 1528446069 | Douglas David Orzel | Dentist | 9021 N Rodgers Ct Se Ste A, Caledonia, MI 49316-7650 | 2015-05-17 |
| 1013321165 | Raymond James Hanna | Dentist | 3766 Elder Rd S, West Bloomfield, MI 48324-2534 | 2014-06-17 |
| 1831536861 | Claude Charles Lerose Jr. | Dentist | 20675 Mack Ave, Grosse Pointe Woods, MI 48236 | 2013-05-31 |
| 1821433566 | Curtis Cardon | Dentist | 5957 Harvey St Ste 200, Norton Shores, MI 49444-9737 | 2013-05-08 |
| 1043568694 | Nick Leone Dds PC | Dentist | 28018 Harper Ave., St. Clair Shores, MI 48081-1562 | 2012-08-29 |
| Find all providers with the same taxonomy | ||||
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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.