DR. LARRY A JOHNSON (NPI# 1811147598) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811147598 |
| Entity Type | Individual |
| Full Name | DR. LARRY A JOHNSON |
| Credential | DDS |
| Practice Address |
69 Hall Road Sturbridge MA 07566 |
| Practice Telephone | 5083472673 |
| Practice Fax Number | 5088475085 |
| Mailing Telephone | 5083472673 |
| Mailing Fax Number | 5088475085 |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2008-09-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 1223P0300X |
Dentist Specialization: Periodontics |
006125 | CT | Dental Providers |
| Y | 1223P0300X |
Dentist Specialization: Periodontics |
12356 | MA | Dental Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801367032 | Larry R Johnson Jr. | Registered Nurse | 5011 State Rd, Fort Gratiot, MI 48059-2909 | 2018-12-16 |
| 1093103491 | Larry Johnson Sr. | Private Vehicle | 600 Lake Air Dr, Suite 3a, Waco, TX 76710-5887 | 2015-01-07 |
| 1578981262 | Larry Johnson | Pharmacist | 18928 Auberry Rd, Clovis, CA 93619-9641 | 2014-03-31 |
| 1841588316 | Larry Brian Johnson | Pharmacist | 37435 Main St, Burney, CA 96013-4372 | 2011-07-18 |
| 1396983888 | Larry Wayne Johnson | Specialist | 9570 Ridgehaven Ct, Suite C, San Diego, CA 92123-1667 | 2009-01-22 |
| 1669448155 | Larry Dean Johnson | Chiropractor | 413 Ne Van Loon Ln, #126, Cape Coral, FL 33909-2525 | 2006-02-24 |
| 1932183043 | Larry Wayne Johnson | Family Medicine | 1015 Garden Lake Pkwy, Toledo, OH 43614-2779 | 2005-12-01 |
| 1275514911 | Larry Hugh Johnson | Family Medicine | 7643 Oak Park Pl Nw, Bremerton, WA 98311-9175 | 2005-11-09 |
| 1487203477 | Larry Darnell Johnson | Social Worker | 1030 5th Ave Se Ste 3000, Cedar Rapids, IA 52403-2416 | 2019-09-11 |
| 1902370281 | Larry D Johnson | Counselor | 4300 Sw 13th St, Gainesville, FL 32608-4006 | 2019-01-19 |
| Street Address |
69 HALL ROAD |
| City | STURBRIDGE |
| State | MA |
| Zip Code | 07566 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437247889 | Larry A Johnson Dds PC | Dentist | 69 Hall Road, Sturbridge, MA 01566 | 2006-10-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538768510 | Adrienne Gail Bachand | Physical Therapist | 57 Main St Ste 4, Sturbridge, MA 01566-1283 | 2020-10-21 |
| 1184221046 | Abdonne Ngo Nyele Mbouadeu | Nurse Practitioner | 34 Tannery Rd, Sturbridge, MA 01518-1171 | 2020-10-05 |
| 1194376574 | Avery Trifone | Behavior Technician | 16 Gedeon Ave, Sturbridge, MA 01566-1537 | 2019-09-26 |
| 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 |
| 1023531175 | Dawn Marie Myers | Physical Therapist | 67 Hall Rd Ste 2, C/o Physical Therapy Innovations, Sturbridge, MA 01566-1473 | 2017-07-20 |
| 1447782537 | Elizabeth Sandstrom | Registered Nurse | 48 Bushnell Rd, Sturbridge, MA 01566-1004 | 2017-03-29 |
| 1568830594 | Katie Beer | Registered Nurse | 1 Old Village Rd, Sturbridge, MA 01566-1041 | 2015-09-08 |
| 1487032124 | Kevin Hughes | Behavioral Analyst | 13 Wallace Rd, Sturbridge, MA 01566-1425 | 2015-05-14 |
| Find all providers in STURBRIDGE | ||||
| 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 |
|---|---|---|---|---|
| 1437247889 | Larry A Johnson Dds PC | Dentist | 69 Hall Road, Sturbridge, MA 01566 | 2006-10-11 |
| 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 | 07566 |
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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.