Emily J Johnson, D.D.S.

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

2011017968 Issued in MO

Practice address

5992 Howdershell Rd
Suite 206
Hazelwood, MO 63042-4107

Phone

(314) 731-2273

NPI assigned

Aug 19, 2011

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

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.

Opted out of Medicare

Yes, effective Dec 31, 2015 through Dec 31, 2027

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.

• David E Wagner DMD LLC

  • Dentist
  • Hazelwood, MO
  • NPI 1942450937
  NPD (past)
• Marden Dental

  • General Practice Dentistry
  • Saint Louis, MO
  • NPI 1255510988
  NPD (past)

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

{
    "created_epoch": "1313712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1377734400000",
    "number": "1487934667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5992 HOWDERSHELL RD",
            "address_2": "SUITE 206",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630424107",
            "telephone_number": "314-731-2273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5992 HOWDERSHELL RD",
            "address_2": "SUITE 206",
            "city": "HAZELWOOD",
            "state": "MO",
            "postal_code": "630424107",
            "telephone_number": "314-731-2273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "EMILY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-19",
        "last_updated": "2013-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MO",
            "license": "2011017968",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thomas Wayne Jasper, O.D.
• Ashley Jenkins, LAT, ATC
• Angel Jennings
• Sorav Jethi
• Ravi S Johar, M.D.
• Faye E Johnson
• Keri P Johnson, MD
• Tara K Johnson
• Lashell Jones
• Qiana Jones, CNA, MOA

• General Practice Dentistry in Hazelwood, MO
• Providers in Hazelwood, MO by specialty
• General Practice Dentistry in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2013; 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.