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Deactivated NPI 1912036708 Deactivated / Inactive NPI Male Practitioner

Dr. Thomas Merle Johnson , DDS

Dentist - Periodontics • Bloomington, IL

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Thomas Johnson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date March 05, 2007
NPI Deactivation Date January 13, 2021
Total Practice Duration ~14 Years of Practice (2007 – 2021)

Professional Overview & Biography Verified Profile Summary

Dr. Thomas Johnson, DDS was a registered Dentist - Periodontics practicing in Bloomington, IL. Throughout an active medical career spanning 14 years, Dr. Johnson provided care at the practice location at 2103 E WASHINGTON ST STE 4A until profile deactivation on 2021-01-13.

Practice Location & Contact Primary Location

Practice Address

2103 E Washington St Ste 4a

Bloomington, IL 617014365

Telephone 3096621357
Fax 3096626287

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - Periodontics in Bloomington, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.0 Yrs
Regional Practice Density
4 Specialists

Practicing in Bloomington, IL (229 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

Dentist - Periodontics Primary Specialty

NUCC Taxonomy Code: 1223P0300X

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.

Career & Practice History Timeline

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

7 Historical Events
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NPI Profile Deactivated January 13, 2021

Record deactivated on January 13, 2021

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 2103 E WASHINGTON ST STE 4A, BLOOMINGTON, IL 617014365 (Tel: 3096621357)

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Updated Business Mailing Address July 08, 2007

Registered at 24 PENDLETON WAY, BLOOMINGTON, IL 617046273 (Tel: 3096625206)

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Provider Name / Credentials Updated July 08, 2007

Recorded as THOMAS JOHNSON, D.D.S.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Dentist

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Initial NPI Registration & Enumeration March 05, 2007

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: 1912036708
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 05, 2007
Last Update: July 08, 2007
Deactivation Date: January 13, 2021

Mailing Address

24 Pendleton Way

Bloomington, IL 617046273

Phone: 3096625206

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.