DR. KIRBY CHARLES JOHNSON DDS
NPI 1023045341
Dentist - Oral and Maxillofacial Surgery in St Anthony, MN

Q: What is Kirby Johnson's NPI number?

The NPI number for Kirby Johnson is 1023045341. It was assigned to this individual provider in the NPPES registry on June 26, 2006.

Q: What is Kirby Johnson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Q: When was this NPI record last updated?

The NPPES record for Kirby Johnson was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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.

Active since June 26, 2006PECOS Enrolled

3905 SILVER LAKE RD, ST ANTHONY, MN 55421(612) 788-9246(612) 788-5511 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 23, 2026.

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About Dr. Kirby Charles Johnson Dds NPPES

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

DR. KIRBY CHARLES JOHNSON DDS (NPI 1023045341) is an individual oral and maxillofacial surgery provider in St Anthony, Minnesota, licensed in Minnesota (10472DDS) and active in the NPI registry since June 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1023045341

Entity TypeIndividualMale

Primary Taxonomy1223S0112X

Provider Legal NameDR. KIRBY CHARLES JOHNSONCredential: DDS

Location Address3905 SILVER LAKE RDSt Anthony, MN 55421

Mailing Address320 Calamus CircleMedina, MN 55340 · (612) 788-9246 · Fax (612) 788-5511

Phone(612) 788-9246

Fax(612) 788-5511

Sole ProprietorNo

Enumeration DateJune 26, 2006

Last NPPES UpdateJuly 8, 2007

✔ NPI 1023045341 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers

Taxonomy Code1223S0112X

License✔ Licensed in MN · 10472DDS

Definition

An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.

3905 SILVER LAKE RD, St Anthony, MN 55421

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Other Identifiers 1

Medicare UPINT93145

Accepted Insurance

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

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kirby Charles 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 55421 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

$85.82 typical visit price

range $56.00 – $168.28

Typical copayment $21.45 (range $14.00 – $42.07)

Most-billed visit code 99203

Established Patient

$69.74 typical visit price

range $18.32 – $138.04

Typical copayment $17.43 (range $4.58 – $34.51)

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.

Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. RICK LYNN DIEHL DDS

Dentist (Oral and Maxillofacial Surgery)

3905 SILVER LAKE RD
ST ANTHONY, MN 55421

Anoka County (612) 788-9246

DR. DANIEL EDGER SAMPSON MD DDS

Dentist (Oral and Maxillofacial Surgery)

3905 SILVER LAKE RD
ST ANTHONY, MN 55421

Anoka County (612) 788-9246

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 Kirby Johnson's NPI number?

The NPI number for Kirby Johnson is 1023045341. It was assigned to this individual provider in the NPPES registry on June 26, 2006.

Where is Kirby Johnson located?

Kirby Johnson practices at 3905 Silver Lake Rd, St Anthony, MN 55421. The listed phone number is (612) 788-9246.

What is Kirby Johnson's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Kirby Johnson enrolled in Medicare?

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

What insurance does Kirby Johnson accept?

Health plans from Anthem Blue Cross and Blue Shield, Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas and Florida Combined Life and 2 other insurers list Kirby 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 Kirby Johnson was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years 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.