Active NPI
Erica M Johannes, DDS
- Dentist
- West Columbia, SC
National Provider Identifier
1881707420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dentist
- License
- 4571
- 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
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 |
|---|---|---|---|---|
| Dentist | 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
| License | State | Type | Specialty |
|---|---|---|---|
| 4571 | SC | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Dentist
- West Columbia, SC
- NPI 1982105904
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.