Nathan M Johannsson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2024024142 Issued in MO

Practice address

246 Lonepine Dr
Wentzville, MO 63385-3504

Phone

(480) 842-1799

NPI assigned

Jan 23, 2007

Last updated

Nov 14, 2025By 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 MO

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

Locations

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.

• Aria Dental Care PC

  • Dentist
  • Overland Park, KS
  • NPI 1942977632

  MO

  Medicare reassignment NPD
• Moon Valley Dental LLC

  dba Moon Valley Dental Care

  • Dental Clinic/Center
  • Phoenix, AZ
  • NPI 1215610555
  NPD (past)

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763078400000",
    "number": "1093869216",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "246 LONEPINE DR",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633853504",
            "telephone_number": "480-842-1799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "246 LONEPINE DR",
            "city": "WENTZVILLE",
            "state": "MO",
            "postal_code": "633853504",
            "telephone_number": "480-842-1799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANNSSON",
        "first_name": "NATHAN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-23",
        "last_updated": "2025-11-14",
        "certification_date": "2025-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MO",
            "license": "2024024142",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stacey E Jeffery, BCBA, LBA
• Timothy Jenkins, LCSW
• Jennifer Blei, D.C., LLC
• Laura L Jennings, RPH
• Diane Marie Jessen, O.D.
• Elizabeth Johnson, FNP
• Ellen Johnson, M.S. , CCC-SLP
• Gregory M Johnson, DDS
• Marcia Michelle Johnson
• Summer Danielle Johnson, PSY.D.

• Dentist in Wentzville, MO
• Providers in Wentzville, MO by specialty
• Dentist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2025; 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.