Richard Mathias Johnson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

5000864015 Issued in WI

Practice address

1507 Tower Ave
RM 427
Superior, WI 54880

Phone

(715) 394-5792

NPI assigned

Jun 15, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Twin Ports Dental

  • General Practice Dentistry
  • Superior, WI
  • NPI 1114230968
  NPD (past)

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

{
    "created_epoch": "1150329600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1376587279",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1507 TOWER AVE",
            "address_2": "RM 427",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "54880",
            "telephone_number": "715-394-5792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1507 TOWER AVE",
            "address_2": "RM 427",
            "city": "SUPERIOR",
            "state": "WI",
            "postal_code": "54880",
            "telephone_number": "715-394-5792"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "RICHARD",
        "middle_name": "MATHIAS",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-15",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "5000864015",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D7559",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "33674700",
            "state": "WI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "90951JO",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ashley Elizabeth Jensen, FNP-BC
• Carole A. Jesberg, RN
• Brent T Johnson, DDS
• Karen Schwoebel Johnson, MS
• Lisa Marie Johnson, PTA
• Sarah Elizabeth Johnson, PA-C
• Tiffany Johnson, C-SAC
• Hannah Johnston, RN
• Rebecca Evelyn Jones, REGISTERED NURSE
• Timothy Jossund

• Dentist in Superior, WI
• Providers in Superior, WI by specialty
• Dentist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; 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.