Christopher M Johnson, DDS

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D11061 Issued in MN

Practice address

425 2ND St
Excelsior, MN 55331-2038

Phone

(952) 474-6133

Fax

(952) 474-7361

NPI assigned

Oct 20, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289433600000",
    "number": "1093704124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10511 E RIVERVIEW DR",
            "city": "EDEN PRAIRIE",
            "state": "MN",
            "postal_code": "553474918",
            "telephone_number": "952-941-9007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 2ND ST",
            "city": "EXCELSIOR",
            "state": "MN",
            "postal_code": "553312038",
            "telephone_number": "952-474-6133",
            "fax_number": "952-474-7361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "CHRISTOPHER",
        "middle_name": "M",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-20",
        "last_updated": "2010-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D11061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MN CARE ID",
            "identifier": "020998800",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael James Isaacson, DC
• Michelle Isaacson, DC
• Jade Cloud
• Jflower Enterprises Incorporated
• Lauren Johnsen, MS, CCC-SLP
• Eleanor Johnson, NP
• Michael C Johnson, D.M.D.
• Newton H Johnson
• Nolan Johnson
• Tyler K Johnson, PA-C

• General Practice Dentistry in Excelsior, MN
• Providers in Excelsior, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2010; 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.