Active NPI
Elizabeth Ann Johnson, D.D.S.
- General Practice Dentistry
- O'Neill, NE
National Provider Identifier
1326112186
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Dentistry
- License
- 5328
- Practice address
- 415 E John St
Oneill, NE 68763-1353 - Phone
- (402) 336-3666
- Fax
- (402) 336-3666
- NPI assigned
- Nov 20, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| General Practice Dentistry | 1223G0001X | 5328 | NE | Primary |
Addresses
Primary practice location
415 E John St
Oneill, NE 68763-1353
Mailing address
87187 W 10TH St
Oneill, NE 68763-4003
Phone (402) 336-4613
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 47069757400 | Medicaid | NE | |
| 05711-NE | Other | NE | BCBS OF NE |
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 |
|---|---|---|---|
| 5328 | NE | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163980800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1326112186",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "87187 W 10TH ST",
"city": "ONEILL",
"state": "NE",
"postal_code": "687634003",
"telephone_number": "402-336-4613"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "415 E JOHN ST",
"city": "ONEILL",
"state": "NE",
"postal_code": "687631353",
"telephone_number": "402-336-3666",
"fax_number": "402-336-3666"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "ELIZABETH",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "D.D.S.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-20",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223G0001X",
"taxonomy_group": "",
"desc": "Dentist, General Practice",
"state": "NE",
"license": "5328",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "47069757400",
"state": "NE"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS OF NE",
"identifier": "05711-NE",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in O'Neill, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.