Dr Gary Robert Johnson, DDS is a medicare enrolled "Dentist - General Practice" provider in Berkeley, Illinois. His current practice location is
5646 Saint Charles Rd, Suite C, Berkeley, Illinois. You can reach out to his office (for appointments etc.) via phone at
(708) 544-7474.
Dr Gary Robert Johnson is licensed to practice in Illinois (license number 019017208) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1649294927.
Healthcare Provider's Profile
Full Name | Dr Gary Robert Johnson |
---|
Gender | Male |
---|
Speciality | Dentist - General Practice |
---|
Location | 5646 Saint Charles Rd, Berkeley, Illinois |
---|
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1649294927
- Provider Enumeration Date: 07/27/2006
- Last Update Date: 10/26/2015
Medicare PECOS Information:
- PECOS PAC ID: 1153623327
- Enrollment ID: I20160105001094
Medical Identifiers
Medical identifiers for Dr Gary Robert Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1649294927 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
1223G0001X | Dentist - General Practice | 019017208 (Illinois) | Primary |
1223G0001X | Dentist - General Practice | 319006856 (Illinois) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Gary Robert Johnson is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Gary Robert Johnson, DDS 5646 Saint Charles Rd, Suite C, Berkeley, IL 60163-1148 Ph: (708) 544-7474 | Dr Gary Robert Johnson, DDS 5646 Saint Charles Rd, Suite C, Berkeley, IL 60163-1148 Ph: (708) 544-7474 |
Reviews and Comments