Kenton M Johnson, DDS MS

Primary specialty

DentistTaxonomy code 122300000X

License

D10828 Issued in MN

Practice address

2690 Sivelling Ave N
Ste 250
Roseville, MN 55113

Phone

(651) 633-1834

Fax

(651) 633-0995

NPI assigned

Apr 27, 2006

Sex

Male

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

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

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.

• Metro Dentalcare, PLC

  • Dentist
  • Lakeville, MN
  • NPI 1316913411
  NPD (past)

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

{
    "created_epoch": "1146096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1477510055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 23029",
            "city": "RICHFIELD",
            "state": "MN",
            "postal_code": "55423",
            "telephone_number": "612-861-9123",
            "fax_number": "612-861-9155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2690 SIVELLING AVE N",
            "address_2": "STE 250",
            "city": "ROSEVILLE",
            "state": "MN",
            "postal_code": "55113",
            "telephone_number": "651-633-1834",
            "fax_number": "651-633-0995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KENTON",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "DDS MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-27",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D10828",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Byron Johnson, MD
• Darrin Lee Johnson, M.D.
• Joshua B Johnson, MD
• Julie Kay Johnson, PHARM.D.
• Keith W. Johnson, M.D.
• Lisa J Johnson
• Mark Robert Johnson, D.C.
• Pamela Johnson, MA, LMFT, LP
• Summer Johnson
• Sean K Johnston, M.D.

• Dentist in Roseville, MN
• Providers in Roseville, MN by specialty
• Dentist in Minnesota

• 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.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.