Rose Margarette Johnson, DENTAL HYGIENIST

Primary specialty

Dental HygienistTaxonomy code 124Q00000X

License

22605 Issued in CA

Practice address

24065 Biggar Lane
Covelo, CA 95428-9542

Phone

(707) 983-6181

Fax

(707) 983-6802

NPI assigned

Jan 22, 2020

Last updated

Jan 22, 2020By the provider in NPPES

Sex

Female

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 1

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Round Valley Indian Health Center, Inc.

  • Clinic/Center
  • Covelo, CA
  • NPI 1669532750
  NPD

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

{
    "created_epoch": "1579651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1396375028",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1373 CARTER WAY",
            "city": "REDDING",
            "state": "CA",
            "postal_code": "960020337",
            "telephone_number": "530-215-6341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24065 BIGGAR LANE",
            "city": "COVELO",
            "state": "CA",
            "postal_code": "954289542",
            "telephone_number": "707-983-6181",
            "fax_number": "707-983-6802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ROSE",
        "middle_name": "MARGARETTE",
        "credential": "DENTAL HYGIENIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-22",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "22605688",
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "",
            "desc": "Dental Hygienist",
            "state": "CA",
            "license": "22605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "942151392",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dasiana Champagne
• Covelo Ambulance Service
• Maria V Danilychev, M.D.
• Eel River Charter School
• Craig B Emerson, DDS
• Stephen Archie Johnson, RN, NP ,PA
• Sarah Kagin
• Someth Lor, D.D.S
• Kevin Joseph Mack, PSY.D.
• Marilyn Sue Magoffin, FNP, CWCN

• Dental Hygienist in Covelo, CA
• Providers in Covelo, CA by specialty
• Dental Hygienist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; 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.