Abby Pershke Johnson, DDS

Primary specialty

Pediatric DentistryTaxonomy code 1223P0221X

License

D12426 Issued in MN

Practice address

4419 Air Base Rd
Hermantown, MN 55811-1847

Phone

(218) 728-2117

Fax

(218) 728-2700

NPI assigned

Aug 10, 2007

Last updated

Jul 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Eversmiles Pediatric Dentistry, PLLC

  • Pediatric Dentistry
  • Hermantown, MN
  • NPI 1285873687
  NPD (past)

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

{
    "created_epoch": "1186704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1922290345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4419 AIR BASE RD",
            "city": "HERMANTOWN",
            "state": "MN",
            "postal_code": "55811",
            "telephone_number": "218-728-2117",
            "fax_number": "218-728-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4419 AIR BASE RD",
            "city": "HERMANTOWN",
            "state": "MN",
            "postal_code": "558111847",
            "telephone_number": "218-728-2117",
            "fax_number": "218-728-2700"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "Fond du Lac Human Services Division",
            "address_2": "927 Trettel Lane",
            "address_purpose": "LOCATION",
            "city": "Cloquet",
            "state": "MN",
            "postal_code": "55720",
            "country_code": "US",
            "telephone_number": "218-879-1227 x2185",
            "fax_number": "218-878-2188",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "ABBY",
        "middle_name": "PERSHKE",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D12426",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "TN",
            "license": "10033",
            "primary": false
        },
        {
            "code": "1223P0221X",
            "taxonomy_group": "",
            "desc": "Dentist, Pediatric Dentistry",
            "state": "MN",
            "license": "D12426",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "D12426",
            "state": "MN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "10033",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christiana Nwanneka Igwe
• Gabriella Louise Jacoby
• Elizabeth A Jatzo
• Sonny Jenkins
• Jessica Podpeskar
• Emily Jean Johnson
• Kaia Mae Johnson, BS
• Katlen Marie Johnson
• Kimberly Ann Johnson, CNP
• Robert Franklyn Johnson, PHARMD, RPH

• Pediatric Dentistry in Hermantown, MN
• Providers in Hermantown, MN by specialty
• Pediatric Dentistry in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.