Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

MR. KENTON M JOHNSON DDS MS
NPI 1477510055
Dentist in Roseville, MN

Q: What is Kenton Johnson's NPI number?

The NPI number for Kenton Johnson is 1477510055. It was assigned to this individual provider in the NPPES registry on April 27, 2006.

Q: What is Kenton Johnson's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Kenton Johnson was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 29 days 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 April 27, 2006PECOS Enrolled

2690 SIVELLING AVE N, STE 250, ROSEVILLE, MN 55113(651) 633-1834(651) 633-0995 Get Directions Write a Review

NPPES record last updated: July 13, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

About Mr. Kenton M Johnson Dds Ms NPPES

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

MR. KENTON M JOHNSON DDS MS (NPI 1477510055) is an individual dentist in Roseville, Minnesota, licensed in Minnesota (D10828) and active in the NPI registry since April 2006. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1477510055

Entity TypeIndividualMale

Primary Taxonomy122300000X

Provider Legal NameMR. KENTON M JOHNSONCredential: DDS MS

Location Address2690 SIVELLING AVE N, STE 250Roseville, MN 55113

Mailing AddressPo Box 23029Richfield, MN 55423 · (612) 861-9123 · Fax (612) 861-9155

Phone(651) 633-1834

Fax(651) 633-0995

Sole ProprietorNo

Enumeration DateApril 27, 2006

Last NPPES UpdateJuly 13, 2026

✔ NPI 1477510055 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentistDental Providers

Taxonomy Code122300000X

License✔ Licensed in MN · D10828

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.

2690 SIVELLING AVE N, Roseville, MN 55113

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Alabama 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)

Mr. Kenton M Johnson Dds Ms 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 55113 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.

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 Kenton Johnson's NPI number?

The NPI number for Kenton Johnson is 1477510055. It was assigned to this individual provider in the NPPES registry on April 27, 2006.

Where is Kenton Johnson located?

Kenton Johnson practices at 2690 Sivelling Ave N Ste 250, Roseville, MN 55113. The listed phone number is (651) 633-1834.

What is Kenton Johnson's specialty?

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

Is Kenton Johnson enrolled in Medicare?

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

What insurance does Kenton Johnson accept?

Health plans from Anthem Blue Cross and Blue Shield, BEST Life, Blue Cross and Blue Shield of Alabama, Blue Cross and Blue Shield of Montana and Blue Cross and Blue Shield of Oklahoma and 6 other insurers list Kenton 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 Kenton Johnson was last updated on July 13, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 29 days 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.