Active NPI
Angela M Johnson, DHAT
- Dental Therapist
- Bellingham, WA
National Provider Identifier
1154919314
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Therapist
- License
- 00002
- Practice address
- 2608 Kwina Rd
Bellingham, WA 98226-9291 - Phone
- (360) 312-2000
- NPI assigned
- Jan 4, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dental Therapist | 125J00000X | 00002 | WA | Primary |
Addresses
Primary practice location
2608 Kwina Rd
Bellingham, WA 98226-9291
Mailing address
2592 Kwina Rd
Bellingham, WA 98226-9278
Phone (360) 312-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00002 | Other | WA | LUMMI COMMUNITY HEALTH AIDE PROGRAM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 00002 | WA | MD | Dental Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1609718400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1715040000000",
"number": "1154919314",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2592 KWINA RD",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982269278",
"telephone_number": "360-312-2000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2608 KWINA RD",
"city": "BELLINGHAM",
"state": "WA",
"postal_code": "982269291",
"telephone_number": "360-312-2000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "ANGELA",
"middle_name": "M",
"credential": "DHAT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-04",
"last_updated": "2024-05-07",
"certification_date": "2024-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "125J00000X",
"taxonomy_group": "",
"desc": "Dental Therapist",
"state": "WA",
"license": "00002",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LUMMI COMMUNITY HEALTH AIDE PROGRAM",
"identifier": "00002",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bellingham, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.