Individual provider Active NPI

Annika Johnson, DDS

  • Oral and Maxillofacial Surgery (Dentist)
  • Charlotte, NC
National Provider Identifier
1124766381
Registry record updated May 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
D14741 Issued in MN
Practice address
8840 Blakeney Professional Dr Ste 300
Charlotte, NC 28277-6749
Phone
(612) 625-0402
NPI assigned
May 26, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 29, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X D14741 MN Primary
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 14567 NC
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 11339 SC

Addresses

Primary practice location

8840 Blakeney Professional Dr Ste 300
Charlotte, NC 28277-6749

Mailing address

6233 115TH St E
Northfield, MN 55057-4426
Phone (507) 649-2216

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20220801002745 MN Order and Referring Only - Maxillofacial SurgeryPractitioner - Maxillofacial Surgery 8628450087

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
D14741MNMDOral and Maxillofacial Surgery (Dentist)
14567NCMDMassage Therapist

NPI Registry JSON

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

{
    "created_epoch": "1653523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780012800000",
    "number": "1124766381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6233 115TH ST E",
            "city": "NORTHFIELD",
            "state": "MN",
            "postal_code": "550574426",
            "telephone_number": "507-649-2216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8840 BLAKENEY PROFESSIONAL DR STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282776749",
            "telephone_number": "612-625-0402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ANNIKA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-05-26",
        "last_updated": "2026-05-29",
        "certification_date": "2026-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "MN",
            "license": "D14741",
            "primary": true
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NC",
            "license": "14567",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "SC",
            "license": "11339",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

Verify at the official NPI Registry.