Active NPI
Michele Dawn Johnson, RDHAP
- Dental Hygienist
- Blue Lake, CA
National Provider Identifier
1205360088
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dental Hygienist
- License
- 654
- Practice address
- 520 Greenwood Ave.
Blue Lake, CA 95525-0903 - Phone
- (707) 668-5683
- Fax
- (707) 845-0088
- NPI assigned
- Apr 18, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 Hygienist | 124Q00000X | 654 | CA | Primary |
Addresses
Primary practice location
520 Greenwood Ave.
Blue Lake, CA 95525-0903
Mailing address
PO Box 903
520 Greenwood Ave.
Blue Lake, CA 95525-0903
Phone (707) 668-5683
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 |
|---|---|---|---|
| 654 | CA | MD | Speech-Language Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1492473600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492473600000",
"number": "1205360088",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 903",
"address_2": "520 GREENWOOD AVE.",
"city": "BLUE LAKE",
"state": "CA",
"postal_code": "955250903",
"telephone_number": "707-668-5683",
"fax_number": "707-845-0088"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "520 GREENWOOD AVE.",
"city": "BLUE LAKE",
"state": "CA",
"postal_code": "955250903",
"telephone_number": "707-668-5683",
"fax_number": "707-845-0088"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "MICHELE",
"middle_name": "DAWN",
"credential": "RDHAP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-04-18",
"last_updated": "2017-04-18",
"status": "A"
},
"taxonomies": [
{
"code": "124Q00000X",
"taxonomy_group": "",
"desc": "Dental Hygienist",
"state": "CA",
"license": "654",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Blue Lake, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.