DR. RICHARD MATHIAS JOHNSON (NPI# 1376587279) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1376587279 |
| Entity Type | Individual |
| Full Name | DR. RICHARD MATHIAS JOHNSON |
| Credential | DDS |
| Practice Address |
1507 Tower Ave Rm 427 Superior WI 54880 |
| Practice Telephone | 7153945792 |
| Mailing Telephone | 7153945792 |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 122300000X | Dentist | D7559 | MN | Dental Providers |
| Y | 122300000X | Dentist | 5000864015 | WI | Dental Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WI | 33674700 | 05 | |
| BCBS | 90951JO | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760005441 | Richard Johnson | Technician | 4614 G St Se, Washington, DC 20019-7833 | 2020-05-28 |
| 1639652423 | Richard Johnson | Counselor | 3203 Star Hill Rd, Mansfield, TX 76063-2375 | 2018-09-08 |
| 1831695113 | Richard A Johnson | Technician/Technologist | 6081 Route 96 Ste 8, Farmington, NY 14425-1062 | 2018-04-04 |
| 1346765138 | Richard Johnson Jr. | Driver | 502 Hazelhurst Ave, Richmond, VA 23222-2825 | 2017-08-14 |
| 1225416506 | Richard Johnson | Internal Medicine | 63 Cottonwood Ln, Briarcliff Manor, NY 10510-2140 | 2015-05-07 |
| 1407126519 | Richard Scott Johnson | Social Worker | 625 S 300 E, Brigham City, UT 84302-2910 | 2012-01-05 |
| 1538439641 | Richard Johnson | Respiratory Therapist, Certified | 9142 Wooded Hill Dr, Corona, CA 92883-9345 | 2012-01-05 |
| 1568698934 | Richard Benjamin Johnson | Anesthesiology | Emory Department of Anesthesiology, 1364 Clifton Road Ne. 3b South, Emory University Hosp, Atlanta, GA 30322-0001 | 2009-05-29 |
| 1538369400 | Richard Stanley Johnson | Internal Medicine | 10644 Old Hammock Way, Wellington, FL 33414 | 2007-07-19 |
| 1679782973 | Richard C Johnson | Denturist | 3720 6th Ave, Ste A, Tacoma, WA 98406-4938 | 2007-05-22 |
| Street Address |
1507 TOWER AVE RM 427 |
| City | SUPERIOR |
| State | WI |
| Zip Code | 54880 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306144597 | Edward C Wipson | Counselor | 1507 Tower Ave, Suite 210, Superior, WI 54880-2532 | 2011-03-11 |
| 1114230968 | Twin Ports Dental | Dentist | 1507 Tower Ave, Room 427, Superior, WI 54880-2532 | 2010-07-22 |
| 1538472907 | Neil Olson | Dentist | 1507 Tower Ave, Room 427, Superior, WI 54880-2532 | 2010-07-14 |
| 1386970630 | Alisha Marie Bliss | Counselor | 1507 Tower Ave, Suite 307, Superior, WI 54880-2532 | 2009-10-21 |
| 1417113259 | Neal Burton O'shaughnessy Jr. | Dentist | 1507 Tower Ave, Suite 410, Superior, WI 54880-2532 | 2008-07-31 |
| 1437332319 | Timothy James Moder | Counselor | 1507 Tower Ave, # 307, Superior, WI 54880-2532 | 2007-12-13 |
| 1063632552 | Arthur David Zehm | Dentist | 1507 Tower Ave, Ste 409, Superior, WI 54880 | 2007-04-26 |
| 1285859041 | Ridgewood Recovery, Inc. | Clinic/Center | 1507 Tower Ave, Suite 307, Superior, WI 54880-2532 | 2007-04-16 |
| 1417026485 | Ronald Keith Underdale | Dentist | 1507 Tower Ave, Suite 211, Superior, WI 54880-2554 | 2006-11-06 |
| 1194828269 | Brent T Johnson | Dentist | 1507 Tower Ave, Suite 202, Superior, WI 54880 | 2006-09-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427194 | Alana Catherine Sullivan | Speech-Language Pathologist | 25 N 25th Street E, Superior, WI 54880 | 2020-11-05 |
| 1710524970 | Sean Wiberg Peterson | Specialist/Technologist | 1810 Catlin Ave, Room 1246, Superior, WI 54880 | 2019-12-06 |
| 1558858936 | Brent Adam Engstrom | Student in an Organized Health Care Education/Training Program | 1410 Nth 23rd Street, Superior, WI 54880 | 2018-04-20 |
| 1558769125 | David Kroll | Specialist | Balknap & Catlin Aves., Superior, WI 54880 | 2014-12-15 |
| 1154670321 | Superior Treatment Center, Inc | Community/Behavioral Health | 1507 Tower Ave Ste 307, Superior, WI 54880 | 2012-09-04 |
| 1548551658 | Dionne Jeannine Corcoran | Midwife | 916 Hammond Ave Ste 222, Superior, WI 54880 | 2011-04-22 |
| 1821235433 | Lauren Ashley Miller | Speech-Language Pathologist | 35 N. 28th Street, Superior, WI 54880 | 2009-01-20 |
| 1528261989 | Stacy Ann Kennelly | Physical Therapist | 1612 N 37th Street, Superior, WI 54880 | 2007-06-06 |
| 1760564942 | James Henry Dobis | Family Medicine | 3520 Tower Avenue, Twin Ports Va Outpatient Clinic, Superior, WI 54880 | 2006-10-19 |
| 1134214398 | Kevin M Mikel | Dentist | 3312 Tower Avenue, Superior, WI 54880 | 2006-10-04 |
| Find all providers in zip 54880 | ||||
| Taxonomy Code | 122300000X |
| Grouping | Dental Providers |
| Classification | Dentist |
| A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: dentists who have a DMD or DDS have the same education. Universities have the prerogative to determine what degree is awarded. Both degrees use the same curriculum requirements set by the American Dental Association's Commission on Dental Accreditation. Generally, three or more years of undergraduate education plus four years of dental school is required to graduate and become a general dentist. State licensing boards accept either degree as equivalent, and both degrees allow licensed individuals to practice the same scope of general dentistry. Additional post-graduate training is required to become a dental specialist. |
| Notes: Source: Council on Dental Education and Licensure, American Dental Association |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679198113 | Gerald Thomas Mikel | Dentist | 3312 Tower Ave, Superior, WI 54880-5302 | 2020-06-10 |
| 1225584071 | Trent Sayers Dental PC | Dentist | 1691 Coalton Rd., Superior, CO 80027 | 2016-08-31 |
| 1386810521 | H. Douglas Clark Jr. | Dentist | 2101 Hill Ave, Superior, WI 54880-5260 | 2008-05-07 |
| 1982814885 | Melinda Harbin Meng | Dentist | 405 Brooklyn Ave, Superior, MT 59872-9607 | 2007-05-22 |
| 1538264395 | Roger Scott Mathis | Dentist | 444 Promenade Dr, Superior, CO 80027-8666 | 2006-09-14 |
| 1477669570 | Ronald Kent Scott | Dentist | 119 Belknap St, Superior, WI 54880-2925 | 2006-08-22 |
| 1790394740 | Omran Zarou | Dentist | 823 Belknap St, Superior, WI 54880-2960 | 2020-07-27 |
| 1457845679 | Alexander James Mcneeley | Dentist | 306 Center Dr, Superior, CO 80027-8625 | 2018-06-20 |
| 1487169827 | Daniel Mease | Dentist | 306 Center Dr, Superior, CO 80027-8625 | 2017-12-07 |
| 1932551751 | Jacob W Ferris | Dentist | 3712 Tower Ave, Suite A, Superior, WI 54880-5567 | 2016-07-05 |
| Find all providers in SUPERIOR | ||||
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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.