TERESA EVELYN JOHNSON DDS MS MPH FASGD NPI 1962563874

NPI Information

  • NPI: 1962563874
  • Provider Name: TERESA EVELYN JOHNSON, DDS, MS, MPH, FASGD
  • Classification: Dentist - 1223G0001X
  • Specialization: General Practice
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 115 DREW AVE SE
    MADELIA, MN
    ZIP 56062
  • Phone: (507) 642-8742

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NPI Details

Teresa Evelyn Johnson, DDS, MS, MPH, FASGD is a general practice dentist in Madelia, MN. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. Teresa Evelyn Johnson, DDS, MS, MPH, FASGD NPI is 1962563874. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

115 DREW AVE SE
MADELIA, MN
ZIP 56062-841
Phone: (507) 642-8742
Fax: (507) 642-2926

The NPI 1962563874 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA).

The enumeration date for this NPI number is 12/13/2006 and was last updated on 2/22/2012.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
11223G0001XDentistGeneral PracticeD10071MINNESOTAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1503822700MEDICAIDMINNESOTA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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