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Deactivated NPI 1114148863 Deactivated / Inactive NPI Male Practitioner

Dr. Charles Eric Johnson , DDS

Dentist - General Practice • Rock Falls, 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. Charles Johnson has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date May 01, 2007
NPI Deactivation Date April 19, 2023
Total Practice Duration ~16 Years of Practice (2007 – 2023)

Professional Overview & Biography Verified Profile Summary

Dr. Charles Johnson, DDS was a registered Dentist - General Practice practicing in Rock Falls, IL. Throughout an active medical career spanning 16 years, Dr. Johnson provided care at the practice location at 1300 W 2ND ST until profile deactivation on 2023-04-19.

Practice Location & Contact Primary Location

Practice Address

1300 W 2nd St

Rock Falls, IL 610711005

Telephone 8156262230
Fax 8156262231
Associated Practice Facility / Clinic
🏢 County Of Whiteside Facility NPI 1699778373

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - General Practice in Rock Falls, IL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 23.0 Yrs
State Avg: 18.0 Yrs
Regional Practice Density
6 Specialists

Practicing in Rock Falls, IL (5581 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 - General Practice Primary Specialty

NUCC Taxonomy Code: 1223G0001X

State License IL AJ-3685053

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

34 Associated Practitioners
Dr. Parveen Varma , MD

Physical Medicine & Rehabilitation - Pain Medicine

NPI 1013082551

Doctor of Medicine (M.D.)

NPI 1083840441

Doctor of Dental Surgery

Jeanne Nailor , APN, FNP-BC

Nurse Practitioner - Family

NPI 1093071581

Advanced Practice Nurse, Family Nurse Practitioner (Board Certified)

Mary Heather

Registered Nurse

NPI 1104301571
Laurie Callan , APN, CWOCN

Nurse Practitioner

NPI 1124177647

Advanced Practice Nurse, CWOCN

Dr. Denice Smith , MD

Family Medicine

NPI 1134171085

Doctor of Medicine (M.D.)

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 April 19, 2023

Record deactivated on April 19, 2023

NPI Profile Active January 31, 2012

NPI status registered as active in NPPES database

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Updated Practice Location January 31, 2012

Registered at 1300 W 2ND ST, ROCK FALLS, IL 610711005 (Tel: 8156262230)

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Updated Business Mailing Address January 31, 2012

Registered at 1300 W 2ND ST, ROCK FALLS, IL 610711005 (Tel: 8156262230)

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Provider Name / Credentials Updated January 31, 2012

Recorded as CHARLES JOHNSON, DDS

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Medical Taxonomy / Specialty Registered (Primary Specialty) January 31, 2012

Dentist (License #AJ-3685053 in IL)

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Initial NPI Registration & Enumeration May 01, 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: 1114148863
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: May 01, 2007
Last Update: January 31, 2012
Deactivation Date: April 19, 2023

Mailing Address

1300 W 2nd St

Rock Falls, IL 610711005

Phone: 8156262230

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.