Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1043297153 Individual Practitioner Male Practitioner

Dr. Dwight Layne Johnson , DMD, MS

Dentist - Periodontics • Walla Walla, WA

Professional Overview & Biography Verified Profile Summary

Dr. Dwight Johnson, DMD, MS is a registered healthcare professional specializing in Dentist - Periodontics in Walla Walla, WA. Practice services are available at 1129 S 2ND AVE STE D under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1129 S 2nd Ave Ste D

Walla Walla, WA 993624100

Telephone 5095161200
Fax 5095161209

Specialty Benchmarks & Practice Insights

Comparative analytics for Dentist - Periodontics in Walla Walla, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
1 Specialists

Practicing in Walla Walla, WA (195 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: 2022-09-14
Dentist - Periodontics Primary Specialty

NUCC Taxonomy Code: 1223P0300X

State License WA DE00010960

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.

Dentist - Periodontics

NUCC Taxonomy Code: 1223P0300X

State License ID D-3382

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.

Dentist - Periodontics

NUCC Taxonomy Code: 1223P0300X

State License UT 376097-9921

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

13 Historical Events
📍
Updated Practice Location September 14, 2022

Registered at 1129 S 2ND AVE STE D, WALLA WALLA, WA 993624100 (Tel: 5095161200)

📍
Updated Business Mailing Address September 14, 2022

Registered at 1129 S 2ND AVE STE D, WALLA WALLA, WA 993624100 (Tel: 5095161200)

NPI Profile Active March 30, 2018

NPI status registered as active in NPPES database

📍
Updated Practice Location March 30, 2018

Registered at 1045 E STEWART AVE BLDG 2012T, 21ST MEDICAL GROUP, PETERSON AFB, CO 809142900 (Tel: 7195561333)

📍
Updated Business Mailing Address March 30, 2018

Registered at 1045 E STEWART AVE BLDG 2012T, 21ST MEDICAL GROUP, PETERSON AFB, CO 809142900 (Tel: 7195561333)

👤
Provider Name / Credentials Updated March 30, 2018

Recorded as DWIGHT JOHNSON, D.M.D., M.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 30, 2018

Dentist (License #D-3382 in ID)

NPI Profile Active September 29, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location September 29, 2016

Registered at 1045 E STEWART AVE BLDG 2012T, 21ST MEDICAL GROUP, PETERSON AFB, CO 809142900 (Tel: 7195561333)

📍
Updated Business Mailing Address September 29, 2016

Registered at 1045 E STEWART AVE BLDG 2012T, 21ST MEDICAL GROUP, PETERSON AFB, CO 809142900 (Tel: 7195561333)

👤
Provider Name / Credentials Updated September 29, 2016

Recorded as DWIGHT JOHNSON, D.M.D., M.S.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 29, 2016

Dentist (License #DE00010960 in WA)

🟢
Initial NPI Registration & Enumeration December 29, 2005

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: 1043297153
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 29, 2005
Last Update: September 14, 2022
Sole Proprietor: No

Mailing Address

1129 S 2nd Ave Ste D

Walla Walla, WA 993624100

Phone: 5095161200

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.