Individual provider Active NPI

Taylor Amarii Johnson, DDS

  • General Practice Dentistry
  • Mount Clemens, MI
National Provider Identifier
1609558683
Registry record updated Sep 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice DentistryTaxonomy code 1223G0001X
License
DN28366 Issued in FL
Practice address
18 Market St Ste C
Mount Clemens, MI 48043
Phone
(586) 783-2222
NPI assigned
Aug 1, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901602404 MI
General Practice Dentistry 1223G0001X DN28366 FL Primary

Addresses

Primary practice location

18 Market St Ste C
Mount Clemens, MI 48043

Mailing address

18 Market St Ste C
Mount Clemens, MI 48043-7403

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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

Enrollment IDStateProvider typePAC IDDetails
I20260225002111 MI Practitioner - Dentist 6103307426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dentist
Education
University of Detroit Mercy School of Dentistry, 2023
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

6800 E 10 Mile Rd
Center Line, MI 48015-1167

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DN28366FLMDGeneral Practice Dentistry
2901602404MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Mycare Health Center CurrentSince Jan 18, 2026 Accepting new patients
Mycare Health Center CurrentSince Jan 18, 2026 Accepting new patients

Locations

6800 E 10 Mile Rd
Center Line, MI 48015

43740 N Groesbeck Hwy
Clinton Twp, MI 48036
Phone (586) 469-7229

18 Market St
Ste C
Mount Clemens, MI 48043
Phone (586) 783-2222

Interoperability endpoints

  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10018231

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1690848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758758400000",
    "number": "1609558683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 MARKET ST STE C",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "480437403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 MARKET ST STE C",
            "city": "MOUNT CLEMENS",
            "state": "MI",
            "postal_code": "48043",
            "telephone_number": "586-783-2222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "TAYLOR",
        "middle_name": "AMARII",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-01",
        "last_updated": "2025-09-25",
        "certification_date": "2025-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901602404",
            "primary": false
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "FL",
            "license": "DN28366",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mount Clemens, MI

Sources for this page

Verify at the official NPI Registry.