Dr Kenneth Arthur Johnson, DDS in Antioch, IL - Medicare Dentist Provider

Dr Kenneth Arthur Johnson, DDS is a medicare enrolled "Dentist - General Practice" provider in Antioch, Illinois. His current practice location is 439 Lake St, Antioch, Illinois. You can reach out to his office (for appointments etc.) via phone at (847) 395-3250.

Dr Kenneth Arthur Johnson is licensed to practice in Illinois (license number 019823) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1497815799.

Contact Information

	Dr Kenneth Arthur Johnson, DDS
	439 Lake St, Antioch, IL 60002-1405
	(847) 395-3250
	(847) 395-4045

Healthcare Provider's Profile

Full Name	Dr Kenneth Arthur Johnson
Gender	Male
Speciality	Dentist - General Practice
Location	439 Lake St, Antioch, Illinois
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1497815799
Provider Enumeration Date: 12/11/2006
Last Update Date: 04/08/2024

Medicare PECOS Information:

PECOS PAC ID: 9537469887
Enrollment ID: I20151118002306

Medical Identifiers

Medical identifiers for Dr Kenneth Arthur Johnson such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1497815799	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
1223G0001X	Dentist - General Practice	019823 (Illinois)	Primary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kenneth Arthur Johnson is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Dr Kenneth Arthur Johnson, DDS 439 Lake St, Antioch, IL 60002-1405 Ph: (847) 395-3250	Dr Kenneth Arthur Johnson, DDS 439 Lake St, Antioch, IL 60002-1405 Ph: (847) 395-3250

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Dentist in Antioch, IL

Dr. Lorelei Lynne Grise', D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 439 Lake St, Antioch, IL 60002 Phone: 847-395-3250 Fax: 847-395-4045
Dr. Jeffrey P. Miles, D.M.D. Dentist Medicare: Not Enrolled in Medicare Practice Location: 417 E Il Route 173, Suite 113, Antioch, IL 60002 Phone: 847-395-5550 Fax: 847-395-5575
Jeff Bang, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 421 Il-173, Antioch, IL 60002 Phone: 224-788-7348
Dr. Brandon B Wood, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 1326 Main St Ste A, Antioch, IL 60002 Phone: 847-395-6166
Dr. Daniel J Boarini, D.D.S. Dentist Medicare: Medicare Enrolled Practice Location: 800 Main St, Antioch, IL 60002 Phone: 847-395-1461 Fax: 847-395-9255
Dr. Kenneth Jazdzewski, DDS Dentist Medicare: Medicare Enrolled Practice Location: 800 Main St, Antioch, IL 60002 Phone: 847-395-1461 Fax: 847-395-9255
Dr. Yousif Tolla, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 550 E Il Route 173, Antioch, IL 60002 Phone: 248-872-0192

Dr Kenneth Arthur Johnson, DDS - Medicare Dentist in Antioch, IL