Dr Mary Ann Johnson, DMD is a
Dentist - General Practice based in Kiowa, Colorado. Dr Mary Ann Johnson is licensed to practice in Colorado (license number DEN.00202717) and her current practice location is
320 Comanche St., Kiowa, Colorado. She can be reached at her office (for appointments etc.) via phone at
(720) 389-9763.
NPI number for Dr Mary Ann Johnson is 1003286055 and her current mailing address is 3205 N Academy Blvd, Suite 130, Colorado Springs, Colorado. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1003286055.
Healthcare Provider's Profile
| Full Name | Dr Mary Ann Johnson |
|---|
| Gender | Female |
|---|
| Speciality | Dentist - General Practice |
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| Location | 320 Comanche St., Kiowa, Colorado |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1003286055
- Provider Enumeration Date: 10/02/2015
- Last Update Date: 04/04/2017
Medical Identifiers
Medical identifiers for Dr Mary Ann Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1003286055 | NPI | - | NPPES |
| 80200079 | Medicaid | CO | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223G0001X | Dentist - General Practice | DEN.00202717 (Colorado) | Primary |
| 122300000X | Dentist | DN011093 (Georgia) | Secondary |
| 122300000X | Dentist | DEN.00202717 (Colorado) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mary Ann Johnson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Mary Ann Johnson, DMD
3205 N Academy Blvd, Suite 130,
Colorado Springs, CO 80917-5147
Ph: (719) 632-5700 | Dr Mary Ann Johnson, DMD
320 Comanche St.,
Kiowa, CO 80117
Ph: (720) 389-9763 |
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