Hillary Noelle Mashak Johnson, DMD

Primary specialty

General Practice DentistryTaxonomy code 1223G0001X

License

D14149 Issued in MN

Practice address

654 Central Ave E
Saint Michael, MN 55376-9632

Phone

(612) 712-5825

NPI assigned

Jun 3, 2019

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": "1559520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1750949012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3601 PARK CENTER BLVD APT 715",
            "city": "ST LOUIS PARK",
            "state": "MN",
            "postal_code": "554162565",
            "telephone_number": "608-632-2566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "654 CENTRAL AVE E",
            "city": "SAINT MICHAEL",
            "state": "MN",
            "postal_code": "553769632",
            "telephone_number": "612-712-5825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MASHAK JOHNSON",
        "first_name": "HILLARY",
        "middle_name": "NOELLE",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-06-03",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D14149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liveability LLC
• Chris Loveless
• Steven Michael Maravelas
• Briehana Rae Martin, MSW, LGSW
• Meiby Liliana Martinez
• Samantha Ann Maske
• Tiffany Cheryl-Ann Maurer
• Matthew Dennes McKeever, PA-C
• Erin Louise McKenzie-Keaveny, MA
• Shannon Marie McMahon

• General Practice Dentistry in Saint Michael, MN
• Providers in Saint Michael, 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 Jan 2, 2020; 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.