Active NPI
Kristin Ann Johannsen, DDS, MSD
- Pediatric Dentistry
- Seattle, WA
National Provider Identifier
1851478341
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Dentistry
- License
- DE00010590
- Practice address
- 1421 NW 85TH St
Seattle, WA 98117-4298 - Phone
- (206) 789-4035
- Fax
- (206) 789-3541
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Dentistry | 1223P0221X | DE00010590 | WA | Primary |
Addresses
Primary practice location
1421 NW 85TH St
Seattle, WA 98117-4298
Mailing address
8505 NE 201St PL
Bothell, WA 98011-2279
Phone (408) 603-7639
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DE00010590 | WA | MD | Pediatric Dentist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1851478341",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8505 NE 201ST PL",
"city": "BOTHELL",
"state": "WA",
"postal_code": "980112279",
"telephone_number": "408-603-7639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1421 NW 85TH ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981174298",
"telephone_number": "206-789-4035",
"fax_number": "206-789-3541"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHANNSEN",
"first_name": "KRISTIN",
"middle_name": "ANN",
"name_prefix": "Dr.",
"credential": "DDS, MSD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "1223P0221X",
"taxonomy_group": "",
"desc": "Dentist, Pediatric Dentistry",
"state": "WA",
"license": "DE00010590",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.