Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Stacy Duane Johnson, DDS

Individual provider General Practice Dentistry · NPI 1568511582

Stacy Duane Johnson, DDS is an Oral Surgery in Greenwood, Indiana. Qualified in 1990, 36 years ago. Licensed in Indiana.

Years since qualifying
36
Licensed in
IN
In the registry since
2007
What do these letters mean?
DDS — Doctor of Dental Surgery
A dentist. DDS and DMD are the same qualification — universities choose which title to award.

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Practice location Address checks out

3056 W Stones Crossing Rd
Greenwood, IN 46143
Phone: (317) 535-7141
Fax: (317) 535-7142
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence 12009239 (IN)

Record details

NPI number1568511582
Entity typeIndividual (Type 1)
GenderMale
Credentials DDS
Sole proprietorNo
NPI enumeratedJanuary 9, 2007
Last updated in NPPESAugust 28, 2007
Mailing address3056 W Stones Crossing Rd, Greenwood, IN 46143

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyORAL SURGERY
Medical schoolOTHER
Graduated 1990 (36 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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