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MALIEKA TRINEE JOHNSON DDS
NPI 1003161969
Dentist - General Practice in San Diego, CA

Active since July 17, 2012PECOS Enrolled
4784 MUIR AVE, SAN DIEGO, CA 92107(619) 518-9000 Get Directions Write a Review

NPPES record last updated: March 3, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Mar 3, 2025, Aug 11, 2016 (2 updates tracked since 2016).

About Malieka Trinee Johnson Dds NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MALIEKA TRINEE JOHNSON DDS (NPI 1003161969) is an individual general practice provider in San Diego, California, licensed in California (61342) and active in the NPI registry since July 2012. She is enrolled in Medicare PECOS and maintains a secondary practice location in Caldwell.

NPPES Registry Identity

NPI1003161969
Entity TypeIndividualFemale
Primary Taxonomy1223G0001X
Provider Legal NameMALIEKA TRINEE JOHNSONCredential: DDS
Location Address4784 MUIR AVESan Diego, CA 92107-2218
Mailing AddressPo Box 881496San Diego, CA 92168-1496 · (619) 518-9000
Phone(619) 518-9000
Sole ProprietorYes
Enumeration DateJuly 17, 2012
Last NPPES UpdateMarch 3, 20252 updates tracked since enumeration
NPPES CertifiedMarch 3, 2025
✔ NPI 1003161969 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyDentist · General PracticeDental Providers
Taxonomy Code1223G0001X
License✔ Licensed in CA · 61342
Definition
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.
Also ListedDentistTaxonomy 122300000X · License 3361474 (ID)
Also ListedDentist · Dental Public HealthTaxonomy 1223D0001X · License 61342 (CA)
4784 MUIR AVE, San Diego, CA 92107
Open in Google Maps ↗

Secondary Practice Location 1

Location 1808 Cleveland BlvdCaldwell, ID 83605-4168 · Phone (208) 459-1025 · Fax (208) 466-5359

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Humana.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Malieka Trinee Johnson Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Malieka Johnson reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Community Health Clinics, Inc.
734 mi
Federally Qualified Health Center (FQHC)
150 2ND ST
Melba, ID 83641
  • Reassigned Medicare billing, Idaho enrollment
  • 71 clinicians in this Medicare group
NPI 1578574521 (208) 495-1011

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92107 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$94.87 typical visit price
range $62.10 – $184.71
Typical copayment $23.71 (range $15.52 – $46.17)
Most-billed visit code 99203
Established Patient
$76.87 typical visit price
range $20.62 – $151.42
Typical copayment $19.21 (range $5.15 – $37.85)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Malieka Johnson's NPI number?

The NPI number for Malieka Johnson is 1003161969. It was assigned to this individual provider in the NPPES registry on July 17, 2012.

Where is Malieka Johnson located?

Malieka Johnson practices at 4784 Muir Ave, San Diego, CA 92107. The listed phone number is (619) 518-9000.

What is Malieka Johnson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Malieka Johnson enrolled in Medicare?

Yes. Malieka Johnson is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Malieka Johnson's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Malieka Johnson reassigns Medicare benefits to Community Health Clinics, Inc. (Melba, ID). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Malieka Johnson's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Malieka Johnson accept?

Health plans from Anthem Blue Cross and Blue Shield and Humana list Malieka Johnson as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Malieka Johnson was last updated on March 3, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.