Mariah Johnson, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

6001464-15 Issued in WI

Practice address

2400 Foxglove Way Ste 1
Hudson, WI 54016-4537

Phone

(715) 386-9711

NPI assigned

Jun 10, 2024

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

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

{
    "created_epoch": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1497597645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 FOXGLOVE WAY STE 1",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540164537",
            "telephone_number": "715-386-9711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 FOXGLOVE WAY STE 1",
            "city": "HUDSON",
            "state": "WI",
            "postal_code": "540164537",
            "telephone_number": "715-386-9711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MARIAH",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-06-10",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WI",
            "license": "6001464-15",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Nicole Johnson
• Jacob Johnson, D.O.
• Jennifer Renee Johnson, RN
• Kathleen O'Keefe Johnson, OTA L
• Kristine Anne Johnson, NP-C
• Samantha Johnson, MS, CCC-SLP
• Stephanie Lynn Johnson, C.N.M
• Steven L Johnson, DO
• Tanner Oskar Johnson, DPT
• Travis Johnson, D.C.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.