KRISTY LYNN JOHNSON D.D.S.
NPI 1679909212
Dentist - Periodontics in Rochester, MN
About Kristy Lynn Johnson D.d.s. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
KRISTY LYNN JOHNSON D.D.S. (NPI 1679909212) is an individual periodontics provider in Rochester, Minnesota, licensed in Minnesota (S110) and active in the NPI registry since September 2013. She has opted out of Medicare through March 13, 2027 and remains eligible to order and refer.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Kristy Lynn 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 March 13, 2017 through March 13, 2027.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 55901 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
ROCHESTER, MN 55901
ROCHESTER, MN 55901
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 Kristy Johnson's NPI number?
The NPI number for Kristy Johnson is 1679909212. It was assigned to this individual provider in the NPPES registry on September 14, 2013.
Where is Kristy Johnson located?
Kristy Johnson practices at 2647 Superior Dr NW, Rochester, MN 55901. The listed phone number is (304) 841-3063.
What is Kristy Johnson's specialty?
The primary specialty registered for this NPI is Dentist, specializing in Periodontics, with taxonomy code 1223P0300X.
Is Kristy Johnson enrolled in Medicare?
No. Kristy Johnson has opted out of Medicare through March 13, 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 Kristy Johnson was last updated on August 10, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 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.
# Kristy Lynn Johnson, D.D.S. · NPI 1679909212
Periodontics provider in Rochester, Minnesota. Individual provider, active in the CMS NPPES registry since September 14, 2013.
## Identity
- **NPI:** 1679909212 (Entity type: Individual)
- **Enumerated:** September 14, 2013
- **Primary specialty:** Dentist - Periodontics · taxonomy 1223P0300X
- **State license:** S110 (Minnesota)
- **Sole proprietor:** No
## Practice location
- **Address:** 2647 SUPERIOR DR NW, Rochester, MN 55901-8525
- **Phone:** (304) 841-3063
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through March 13, 2027); services are provided under private contract
## Record status
- **NPPES last updated:** August 10, 2021
---
Source: [NPI Profile](https://npiprofile.com/npi/1679909212) · Data from the CMS NPPES public registry.