DR. KENT E JOHNSON D.D.S.
NPI 1083741755
Dentist in Moberly, MO

Q: What is Kent Johnson's NPI number?

The NPI number for Kent Johnson is 1083741755. It was assigned to this individual provider in the NPPES registry on February 28, 2007.

Q: What is Kent Johnson's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Q: Is Kent Johnson enrolled in Medicare?

No. Kent Johnson has opted out of Medicare through November 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

Q: When was this NPI record last updated?

The NPPES record for Kent 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 February 28, 2007Opted out of Medicare · through Nov 1, 2027

1513 UNION AVE, SUITE 2100, MOBERLY, MO 65270(660) 263-6642(660) 263-0752 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: August 02, 2026.

On this page

About Dr. Kent E Johnson D.d.s. NPPES

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

DR. KENT E JOHNSON D.D.S. (NPI 1083741755) is an individual dentist in Moberly, Missouri, licensed in Missouri (013322) and active in the NPI registry since February 2007. He has opted out of Medicare through November 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1083741755

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameDR. KENT E JOHNSONCredential: D.D.S.

Location Address1513 UNION AVE, SUITE 2100Moberly, MO 65270-9407

Mailing Address1513 Union Ave, Suite 2100Moberly, MO 65270-9407 · (660) 263-6642 · Fax (660) 263-0752

Phone(660) 263-6642

Fax(660) 263-0752

Sole ProprietorNo

Enumeration DateFebruary 28, 2007

Last NPPES UpdateJuly 8, 2007

✔ NPI 1083741755 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in MO · 013322

Definition

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.

1513 UNION AVE, Moberly, MO 65270

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Dr. Kent E Johnson D.d.s. has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 1, 2015 through November 1, 2027.

Opt-Out Effective DateNovember 1, 2015

Opt-Out In Effect ThroughNovember 1, 2027Opt-out affidavits renew automatically every two years unless cancelled

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65270 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

$81.64 typical visit price

range $52.28 – $161.24

Typical copayment $20.41 (range $13.07 – $40.31)

Most-billed visit code 99203

Established Patient

$65.71 typical visit price

range $16.30 – $131.05

Typical copayment $16.42 (range $4.07 – $32.76)

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 10

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

DR. IQBAL AKHTAR YAR KHAN M.D.

Psychiatry & Neurology (Neurology)

1513 UNION AVE, SUITE 2800
MOBERLY, MO 65270

Randolph County (660) 263-4434

JONATHON FALLIS DPM LLC

Podiatrist

1513 UNION AVE, SUITE 1400
MOBERLY, MO 65270

Randolph County (660) 263-6688

DR. SAMUEL LIVAUDOIS SIMPSON MD

Pediatrics

1513 UNION AVE, SUITE 2300
MOBERLY, MO 65270

Randolph County (660) 263-8309

MOBERLY MEDICAL CLINICS INC

Clinic/Center (Multi-Specialty)

1513 UNION AVE, SUITE 2300
MOBERLY, MO 65270

Randolph County (660) 263-8309

MOBERLY PHYSICIANS CORP

Family Medicine

1513 UNION AVE, SUITE 1600
MOBERLY, MO 65270

Randolph County (660) 263-4770

DR. JAMES H BYLAND D.D.S.

Dentist

1513 UNION AVE, SUITE 2100
MOBERLY, MO 65270

Randolph County (660) 263-6642

HOUSAM SOUKIEH MD

Internal Medicine (Pulmonary Disease)

1513 UNION AVE, SUITE 1600
MOBERLY, MO 65270

Randolph County (660) 263-2400

DR. JONATHON LEE FALLIS DPM

Podiatrist

1513 UNION AVE, SUITE 1400
MOBERLY, MO 65270

Randolph County (660) 263-6677

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 Kent Johnson's NPI number?

The NPI number for Kent Johnson is 1083741755. It was assigned to this individual provider in the NPPES registry on February 28, 2007.

Where is Kent Johnson located?

Kent Johnson practices at 1513 Union Ave Suite 2100, Moberly, MO 65270. The listed phone number is (660) 263-6642.

What is Kent Johnson's specialty?

The primary specialty registered for this NPI is Dentist with taxonomy code 122300000X.

Is Kent Johnson enrolled in Medicare?

No. Kent Johnson has opted out of Medicare through November 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Kent 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.