Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1730292517 Individual Practitioner Male Practitioner

Dr. Douglas L Johnson , DMD

Oral & Maxillofacial Surgery • St Augustine, FL

Professional Overview & Biography Verified Profile Summary

Dr. Douglas Johnson, DMD is a registered healthcare professional specializing in Oral & Maxillofacial Surgery in St Augustine, FL. Practice services are available at 1301 PLANTATION ISLAND DR S STE 101 under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1301 Plantation Island Dr S Ste 101

St Augustine, FL 320803109

Telephone 9044397980
Fax 9044600506
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Oral & Maxillofacial Surgery in St Augustine, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 20.1 Yrs
Regional Practice Density
1 Specialists

Practicing in St Augustine, FL (79 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2026-05-29
Oral & Maxillofacial Surgery Primary Specialty

NUCC Taxonomy Code: 204E00000X

State License FL DN15568

Oral and maxillofacial surgeons are trained to recognize and treat a wide spectrum of diseases, injuries and defects in the head, neck, face, jaws and the hard and soft tissues of the oral and maxillofacial region. They are also trained to administer anesthesia, and provide care in an office setting. They are trained to treat problems such as the extraction of wisdom teeth, misaligned jaws, tumors and cysts of the jaw and mouth, and to perform dental implant surgery.

Plastic Surgery - Plastic Surgery Within the Head and Neck

NUCC Taxonomy Code: 2082S0099X

State License FL DN15568

A plastic surgeon with additional training in plastic and reconstructive procedures within the head, face, neck and associated structures, including cutaneous head and neck oncology and reconstruction, management of maxillofacial trauma, soft tissue repair and neural surgery. The field is diverse and involves a wide age range of patients, from the newborn to the aged. While both cosmetic and reconstructive surgery is practiced, there are many additional procedures which interface with them.

Dentist - Oral and Maxillofacial Surgery

NUCC Taxonomy Code: 1223S0112X

State License FL DN15568

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.

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID United Concordia
1615570
Commercial Insurance / Payer ID Delta Dental Of Florida
000415568 (FL)
Commercial Insurance / Payer ID Bcbs Ins
84009 (FL)
Commercial Insurance / Payer ID Fl Health Kids
B15568-1 (FL)
Commercial Insurance / Payer ID Railroad Medicare Individual
P00237430 (FL)
Commercial Insurance / Payer ID Southcare Medical Ppo
20-0618977

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

8 Historical Events
📍
Updated Practice Location May 29, 2026

Registered at 1301 PLANTATION ISLAND DR S STE 101, ST AUGUSTINE, FL 320803109 (Tel: 9044397980)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 29, 2026

Plastic Surgery (License #DN15568 in FL)

NPI Profile Active June 23, 2008

NPI status registered as active in NPPES database

📍
Updated Practice Location June 23, 2008

Registered at 1301 PLANTATION ISLAND DR S, SUITE 101, ST AUGUSTINE, FL 320803108 (Tel: 9044600505)

📍
Updated Business Mailing Address June 23, 2008

Registered at PO BOX 7870, SPRINGDALE, AR 727667870 (Tel: 4794645824)

👤
Provider Name / Credentials Updated June 23, 2008

Recorded as DOUGLAS JOHNSON, DMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 23, 2008

Dentist (License #DN15568 in FL)

🟢
Initial NPI Registration & Enumeration August 16, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1730292517
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 16, 2006
Last Update: May 29, 2026
Sole Proprietor: No

Mailing Address

Po Box 7870

Springdale, AR 727667870

Phone: 4794645824

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.