Individual provider Active NPI

Heidi Rene Johnson, D.D.S.

  • Dentist
  • Mukilteo, WA
National Provider Identifier
1902281496
Registry record updated Feb 12, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DentistTaxonomy code 122300000X
License
DE60579213 Issued in WA
Practice address
700 3Rd St Ste a
Mukilteo, WA 98275-1578
Phone
(425) 918-5812
Fax
(855) 264-3656
NPI assigned
Jul 25, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DE60579213 WA Primary

Addresses

Primary practice location

700 3Rd St Ste a
Mukilteo, WA 98275-1578

Mailing address

700 3Rd St Ste a
Mukilteo, WA 98275-1578
Phone (425) 918-5812

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
DE60579213WAMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
M Etemadi DMD PLLC Dentist CurrentSince Nov 9, 2025 Accepting new patients
Heidi Johnson DDS, PLLC CurrentSince Jul 24, 2022 Accepting new patients
Evergreen Family Dentistry Bellevue Dentist Past Accepting new patients

Locations

2121 Madison St
Ste A
Everett, WA 98203
Phone (425) 353-5854

700 3rd St
Ste A
Mukilteo, WA 98275
Phone (425) 918-5812

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1437782400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770854400000",
    "number": "1902281496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 3RD ST STE A",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982751578",
            "telephone_number": "425-918-5812",
            "fax_number": "855-264-3656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "700 3RD ST STE A",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982751578",
            "telephone_number": "425-918-5812",
            "fax_number": "855-264-3656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "HEIDI",
        "middle_name": "RENE",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-07-25",
        "last_updated": "2026-02-12",
        "certification_date": "2026-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "WA",
            "license": "DE60579213",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mukilteo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2026; 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.