KIRBY M. JOHNSON, D.D.S., LLC (NPI# 1841686359) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1841686359 |
| Entity Type | Organization |
| Organization Name | KIRBY M. JOHNSON, D.D.S., LLC |
| Other Organization Name | GREEN LAKE DENTAL |
| Practice Address |
301 Highway 23 Suite 2 Spicer MN 56288-8001 |
| Practice Telephone | 3207962158 |
| Practice Fax Number | 3204091180 |
| Mailing Telephone | 3207962158 |
| Mailing Fax Number | 3204091180 |
| Enumeration Date | 2015-04-10 |
| Last Update Date | 2017-02-24 |
| Authorized Official Name | DR. KIRBY MELVIN JOHNSON (PRESIDENT) |
| Authorized Official Telephone | 3204448075 |
| Authorized Official Credential | D.D.S. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QD0000X |
Clinic/Center Specialization: Dental |
D13361 | MN | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Green Lake Dental | Doing Business As Name - Organization |
| Street Address |
301 HIGHWAY 23 SUITE 2 |
| City | SPICER |
| State | MN |
| Zip Code | 56288-8001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962557587 | Mark Arnold Bloomquist | Dentist | 315 Access Dr, Spicer, MN 56288 | 2007-01-24 |
| 1689723942 | Susan Kay Zanin | Psychologist | 15130 57th St Ne, Spicer, MN 56288 | 2007-01-09 |
| 1548706369 | Rebecca Ann Reichard | Counselor | 215 Milky Way Street South, Cosmos, MN 56288 | 2017-01-18 |
| 1922263441 | Focus Chiropractic & Wellness | Clinic/Center | 180 Progress Way, Spicer, MN 56288-0053 | 2008-07-24 |
| 1821202359 | Paynesville Area Hospital District | Clinic/Center | 300 Highway 23, Suite 4, Spicer, MN 56288-4607 | 2007-05-10 |
| 1639791932 | Peterson Wellness Clinic P.a. | Chiropractor | 194 Progress Way, Spicer, MN 56288-5000 | 2020-05-11 |
| 1083236384 | Zachary Leland Peterson | Chiropractor | 194 Progress Way, Spicer, MN 56288-5000 | 2020-05-11 |
| 1326660622 | Brooke Sara Peterson | Chiropractor | 194 Progress Way, Spicer, MN 56288-5000 | 2020-05-11 |
| 1033553169 | Katie Marie Ross | Pharmacist | 5260 128th Ave Ne, Spicer, MN 56288-8419 | 2013-04-19 |
| 1114114774 | Joanne Louise Thurston | Marriage & Family Therapist | 9196 Lake Ave S, Spicer, MN 56288-8619 | 2007-09-27 |
| Find all providers in zip 56288 | ||||
| Taxonomy Code | 261QD0000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Dental |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033710025 | Theresa M. Snell | Clinic/Center | 580 5th Ave Nw Ste 100, New Brighton, MN 55112-2836 | 2020-11-05 |
| 1376143248 | James M. Williams, D.d.s., P.a. | Clinic/Center | 620 Union St S, Mora, MN 55051-1818 | 2020-10-29 |
| 1235746058 | Asp Dental, PC | Clinic/Center | 17705 Hutchins Dr Ste 201, Minnetonka, MN 55345-4103 | 2020-09-25 |
| 1952918781 | Asp Dental, PC | Clinic/Center | 9800 Shelard Pkwy Ste 130, Plymouth, MN 55441-6451 | 2020-09-25 |
| 1518574532 | Stillwater Family Dental | Clinic/Center | 13481 60th St N Ste 100, Oak Park Heights, MN 55082-1089 | 2020-09-24 |
| 1093321531 | Barnett Dental Inc | Clinic/Center | 7962 Sunwood Dr Nw Ste 200, Ramsey, MN 55303-5172 | 2020-09-21 |
| 1356955868 | Todd A Brewer Dds Pllc | Clinic/Center | 603 Jefferson Ave Sw, Watertown, MN 55388 | 2020-09-02 |
| 1770195158 | Mark T. Sherman Dds Pa | Clinic/Center | 31011 Rasmussen Rd, Pequot Lakes, MN 56472-1227 | 2020-08-18 |
| 1689286015 | Lifelong Dental Care | Clinic/Center | 1525 Livingston Ave Ste B, West St Paul, MN 55118-3430 | 2020-08-18 |
| 1528678497 | Custom Smiles Dentistry, Pllc | Clinic/Center | 2258 Bunker Lake Blvd Nw, Andover, MN 55304-3900 | 2020-08-05 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.