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DR. DOUGLAS L JOHNSON DMD
NPI 1730292517
Oral & Maxillofacial Surgery in St Augustine, FL

Active since August 16, 2006Opted out of Medicare · through Apr 2, 2027
1301 PLANTATION ISLAND DR S STE 101, ST AUGUSTINE, FL 32080(904) 439-7980(904) 460-0506 Get Directions Write a Review

NPPES record last updated: May 29, 2026. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Douglas L Johnson Dmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. DOUGLAS L JOHNSON DMD (NPI 1730292517) is an individual oral & maxillofacial surgery provider in St Augustine, Florida, licensed in Florida (DN15568) and active in the NPI registry since August 2006. He has opted out of Medicare through April 2, 2027.

NPPES Registry Identity

NPI1730292517
Entity TypeIndividualMale
Primary Taxonomy204E00000X
Provider Legal NameDR. DOUGLAS L JOHNSONCredential: DMD
Location Address1301 PLANTATION ISLAND DR S STE 101St Augustine, FL 32080-3109
Mailing AddressPo Box 7870Springdale, AR 72766-7870 · (479) 464-5824 · Fax (479) 725-2395
Phone(904) 439-7980
Fax(904) 460-0506
Sole ProprietorNo
Enumeration DateAugust 16, 2006
Last NPPES UpdateMay 29, 2026
NPPES CertifiedMay 29, 2026
✔ NPI 1730292517 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyOral & Maxillofacial SurgeryAllopathic & Osteopathic Physicians
Taxonomy Code204E00000X
License✔ Licensed in FL · DN15568
Definition
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.
Also ListedDentist · Oral and Maxillofacial SurgeryTaxonomy 1223S0112X · License DN15568 (FL)
Also ListedPlastic Surgery · Plastic Surgery Within the Head and NeckTaxonomy 2082S0099X · License DN15568 (FL)
1301 PLANTATION ISLAND DR S STE 101, St Augustine, FL 32080
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Other Identifiers 6

Other1615570United Concordia
Other000415568FL · Delta Dental Of Florida
Other84009FL · Bcbs Ins
OtherB15568-1FL · Fl Health Kids
OtherP00237430FL · Railroad Medicare Individual
Other20-0618977Southcare Medical Ppo

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

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Opted out of Medicare

Dr. Douglas L Johnson Dmd has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from April 2, 2013 through April 2, 2027.

Opt-Out Effective DateApril 2, 2013
Opt-Out In Effect ThroughApril 2, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Douglas Johnson's NPI number?

The NPI number for Douglas Johnson is 1730292517. It was assigned to this individual provider in the NPPES registry on August 16, 2006.

Where is Douglas Johnson located?

Douglas Johnson practices at 1301 Plantation Island Dr S Ste 101, St Augustine, FL 32080. The listed phone number is (904) 439-7980.

What is Douglas Johnson's specialty?

The primary specialty registered for this NPI is Oral & Maxillofacial Surgery with taxonomy code 204E00000X.

Is Douglas Johnson enrolled in Medicare?

No. Douglas Johnson has opted out of Medicare through April 2, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

What insurance does Douglas Johnson accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, Delta Dental and Florida Blue (BlueCross BlueShield FL) and 2 other insurers list Douglas Johnson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Douglas Johnson was last updated on May 29, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.