Mary Carol Johnson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

6856 Issued in IA

Practice address

711 High St
Des Moines, IA 50392-0001

Phone

(515) 362-2676

Fax

(515) 613-6452

NPI assigned

Mar 16, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1254182400000",
    "number": "1164546305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 HIGH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503920001",
            "telephone_number": "515-362-2676",
            "fax_number": "515-613-6452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "711 HIGH ST",
            "city": "DES MOINES",
            "state": "IA",
            "postal_code": "503920001",
            "telephone_number": "515-362-2676",
            "fax_number": "515-613-6452"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARY",
        "middle_name": "CAROL",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-16",
        "last_updated": "2009-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "IA",
            "license": "6856",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0209320",
            "state": "IA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DELTA DENTAL PROVIDER #",
            "identifier": "20932",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kirsten Jane Johnson, MSN, ARNP, AGACNP-BC
• Kylie Jean Johnson, DNP, ARNP, FNP-C
• Laura Ann Johnson, PHARM D
• Mark Christopher Johnson, M.D.
• Marsha Kay Johnson
• Michaela Jill Johnson, DDS
• Misti Nicole-Smith Johnson, LISW
• Moriah Jean Johnson, PA-C
• Sarah Elizabeth Johnson, ARNP
• Sarah Kay Johnson, TCADC

• Dentist in Des Moines, IA
• Providers in Des Moines, IA by specialty
• Dentist in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.