Kia Sherette Marley Johnson, DMD

Primary specialty

DentistTaxonomy code 122300000X

License

10350 Issued in NC

Practice address

1901 Westridge Rd Ste 102
Greensboro, NC 27410-2425

Phone

(336) 517-1132

NPI assigned

Feb 15, 2016

Sex

Female

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 NC

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 and National Provider Directory roles.

• Kia Johnson DMD PLLC

  • Dentist
  • High Point, NC
  • NPI 1295532091
  NPD Authorized official
• Lane and Associates L DDS PA

  • Dentist
  • Greensboro, NC
  • NPI 1841987229
  NPD

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

{
    "created_epoch": "1455494400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694131200000",
    "number": "1205295680",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 PETERS CREEK PKWY STE 16-19",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271273726",
            "telephone_number": "336-293-8728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 WESTRIDGE RD STE 102",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274102425",
            "telephone_number": "336-517-1132"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2101 Peters Creek Pkwy Ste 16-19",
            "address_purpose": "LOCATION",
            "city": "Winston Salem",
            "state": "NC",
            "postal_code": "27127",
            "country_code": "US",
            "telephone_number": "336-293-8728 x522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KIA",
        "middle_name": "SHERETTE MARLEY",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-02-15",
        "last_updated": "2023-09-08",
        "certification_date": "2023-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NC",
            "license": "10350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Rose Johnson, PA-C
• Kathy La Rue Johnson
• Kelly Rayburn Johnson, PA-C
• Kelsey Johnson
• Kerrie Lynn Johnson, LPC
• Krista Johnson, LCMHC
• Krista Jean Johnson, PA-C
• Krystal Marie Johnson, NCC
• Lauren Williams Johnson, MS, OTR/L
• Lisa Johnson, RD, LDN

• Dentist in Greensboro, NC
• Providers in Greensboro, NC by specialty
• Dentist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2023; 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.