Andrew Paullin Johnson, D.M.D.

Primary specialty

DentistTaxonomy code 122300000X

License

DE00010277 Issued in WA

Practice address

605 S Coolidge St
Moses Lake, WA 98837-1873

Phone

(509) 765-0674

NPI assigned

Dec 4, 2006

Last updated

Jan 23, 2026By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Networks

• WA PPO C-SNP

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Andrew P Johnson, DMD,Inc

  • Dentist
  • E Wenatchee, WA
  • NPI 1649560418
  Authorized official Same address or phone
• Ephrata Community Dental Clinic

  • Federally Qualified Health Center (FQHC)
  • Ephrata, WA
  • NPI 1023597119
  NPD (past)
• Moses Lake Community Health Center

  • Dental Clinic/Center
  • Moses Lake, WA
  • NPI 1386858652
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769126400000",
    "number": "1053479279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 S COOLIDGE ST",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371873",
            "telephone_number": "509-679-5352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 S COOLIDGE ST",
            "city": "MOSES LAKE",
            "state": "WA",
            "postal_code": "988371873",
            "telephone_number": "509-765-0674"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1450 1st Ave SW",
            "address_purpose": "LOCATION",
            "city": "Quincy",
            "state": "WA",
            "postal_code": "988481695",
            "country_code": "US",
            "telephone_number": "509-787-6423",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "457 1st Ave NW",
            "address_purpose": "LOCATION",
            "city": "Ephrata",
            "state": "WA",
            "postal_code": "988232422",
            "country_code": "US",
            "telephone_number": "509-754-6199",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANDREW",
        "middle_name": "PAULLIN",
        "credential": "D.M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-04",
        "last_updated": "2026-01-23",
        "certification_date": "2026-01-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE00010277",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn L Jansen, RDH
• JD and SN Inc (Moses Lake Professional Pharmacy)
• Daniel C Jeffcoat, MD
• Abdusebur M Jemal, MD
• Alexander Alide Johnson, DO
• Deborah Johnson
• Marilee Sue Johnson, MS
• Michael Johnson, PA
• Brent C Jones
• Gregg Moyle Jones, DC

• Dentist in Moses Lake, WA
• Providers in Moses Lake, WA by specialty
• Dentist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.