Individual provider Active NPI

Erica M Johannes, DDS

  • Dentist
  • West Columbia, SC
National Provider Identifier
1881707420
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
4571 Issued in SC
Practice address
3020 Sunset Blvd Ste 106
West Columbia, SC 29169-3494
Phone
(803) 233-1980
Fax
(803) 602-6397
NPI assigned
Aug 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X 4571 SC Primary

Addresses

Primary practice location

3020 Sunset Blvd Ste 106
West Columbia, SC 29169-3494

Mailing address

112 Mallard Lakes CT
Lexington, SC 29072-9300
Phone (920) 254-9865

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

LicenseStateTypeSpecialty
4571SCMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Sweet Tooth Smiles P a Dentist Current Accepting new patients

Locations

3731 Forest Dr
Columbia, SC 29204
Phone (803) 782-5492

3020 Sunset Blvd
Ste 106
West Columbia, SC 29169
Phone (803) 233-1980

Organizations & group practices 1

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": "1155772800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1881707420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "112 MALLARD LAKES CT",
            "city": "LEXINGTON",
            "state": "SC",
            "postal_code": "290729300",
            "telephone_number": "920-254-9865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 SUNSET BLVD STE 106",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291693494",
            "telephone_number": "803-233-1980",
            "fax_number": "803-602-6397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANNES",
        "first_name": "ERICA",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-17",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": "SC",
            "license": "4571",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; 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.