Taylor Johnson

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D14245 Issued in MN

Practice address

10155 University Ave NE Ste 112
Blaine, MN 55434-8058

Phone

(763) 784-1242

NPI assigned

Jul 22, 2019

Last updated

Jul 22, 2019By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• University Ave Dental, PLLC

  • General Practice Dentistry
  • Blaine, MN
  • NPI 1093468852
  NPD
• Don Blakeslee DDS PA

  dba Blakeslee Dental

  • Dentist
  • Blaine, MN
  • NPI 1194949511
  NPD (past)

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563753600000",
    "number": "1396398160",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6801 PAIUTE DR",
            "city": "EDINA",
            "state": "MN",
            "postal_code": "554391032",
            "telephone_number": "952-826-9758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10155 UNIVERSITY AVE NE STE 112",
            "city": "BLAINE",
            "state": "MN",
            "postal_code": "554348058",
            "telephone_number": "763-784-1242"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TAYLOR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-22",
        "last_updated": "2019-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14245",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ashley Emma Jerde, DC
• Johnson Custom Services, LLC (Senior Helpers North Metro)
• Amy Lyn Johnson, ABO
• Kris David Johnson, D.D.S.
• Steven Alan Johnson, CMT
• Alison Joy Jones, PHARMD
• Josh Christopher Jones, D.C.
• Pamela Kay Jones, BFA,MS,D.O.M.,L.AC.
• Kira Jorgensen Duus, PA-C
• Dennis Taylor Jorgenson-Rathke, PA-C

• General Practice Dentistry in Blaine, MN
• Providers in Blaine, MN by specialty
• General Practice Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2019; 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.