Jennifer Ann Marker Johnson, D.D.S.

Primary specialty

DentistTaxonomy code 122300000X

License

D11143 Issued in MN

Practice address

1346 Payne Ave
Saint Paul, MN 55130-3450

Phone

(651) 774-6085

Fax

(651) 774-1220

NPI assigned

Mar 16, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Inside Edge Dental PLLC

  dba East Dental

  • General Practice Dentistry
  • Saint Paul, MN
  • NPI 1114360492
  NPD (past) Authorized official

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1982673570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1346 PAYNE AVE",
            "city": "ST. PAUL",
            "state": "MN",
            "postal_code": "55130",
            "telephone_number": "651-774-6085",
            "fax_number": "651-774-2660"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1346 PAYNE AVE",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551303450",
            "telephone_number": "651-774-6085",
            "fax_number": "651-774-1220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARKER JOHNSON",
        "first_name": "JENNIFER",
        "middle_name": "ANN",
        "name_prefix": "Dr.",
        "credential": "D.D.S.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "MN",
            "license": "D11143",
            "primary": true
        },
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MN",
            "license": "D11143",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Lavern Maristuen, D.C.
• Mitchell Dale Maristuen, D.C
• Mark F. Lavallie, D.C.
• Mark I. Malterud, D.D.S., P.a.
• Susan L Mark, M.D.
• Ruth Brooke Markowitz, MA LICENSED PSYCHOLO
• Anne Marks, RN
• Anne Markus
• Gregory Marn, PHARM D
• Marna Reed, Ma, LP

• Dentist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Dentist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.